Healthcare Provider Details

I. General information

NPI: 1104841881
Provider Name (Legal Business Name): PATTI J YERKE MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 GENOA BUSINESS PARK DR STE 180
BRIGHTON MI
48114-7374
US

IV. Provider business mailing address

12885 STONEYBROOKE CT
SOUTH LYON MI
48178-8533
US

V. Phone/Fax

Practice location:
  • Phone: 810-220-2787
  • Fax: 810-220-2834
Mailing address:
  • Phone: 248-437-3758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801057383
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: