Healthcare Provider Details

I. General information

NPI: 1902245137
Provider Name (Legal Business Name): REBECCA JANE ESPITIA LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2013
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5812 QUEBEC AVE
ANN ARBOR MI
48103-8806
US

IV. Provider business mailing address

5812 QUEBEC AVE
ANN ARBOR MI
48103-8806
US

V. Phone/Fax

Practice location:
  • Phone: 517-294-6694
  • Fax:
Mailing address:
  • Phone: 517-294-6694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801092865
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: