Healthcare Provider Details

I. General information

NPI: 1487096988
Provider Name (Legal Business Name): ROSEMARY URBANO-SPENCER MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2013
Last Update Date: 07/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19855 OUTER DR STE 104
DEARBORN MI
48124-2022
US

IV. Provider business mailing address

8136 RIVERDALE ST
DEARBORN HEIGHTS MI
48127-1569
US

V. Phone/Fax

Practice location:
  • Phone: 313-274-5840
  • Fax: 313-274-8277
Mailing address:
  • Phone: 313-274-5840
  • Fax: 313-274-8277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801092804
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: