Healthcare Provider Details
I. General information
NPI: 1326369158
Provider Name (Legal Business Name): CATHERINE COHAN SPINNEY MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/16/2010
Last Update Date: 10/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20303 KELLY RD
DETROIT MI
48225-1206
US
IV. Provider business mailing address
1740 HAWTHORNE RD
GROSSE POINTE WOODS MI
48236-1469
US
V. Phone/Fax
- Phone: 313-245-7000
- Fax: 313-245-7009
- Phone: 313-475-7849
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 6801092097 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: