Healthcare Provider Details

I. General information

NPI: 1184916512
Provider Name (Legal Business Name): ERIN KRAJCIK LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2011
Last Update Date: 05/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2355 W STADIUM BLVD
ANN ARBOR MI
48103-3852
US

IV. Provider business mailing address

921 WESTWOOD AVE
ANN ARBOR MI
48103-3562
US

V. Phone/Fax

Practice location:
  • Phone: 734-996-9111
  • Fax:
Mailing address:
  • Phone: 734-891-0024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801088977
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: