Healthcare Provider Details

I. General information

NPI: 1245244805
Provider Name (Legal Business Name): MARJORIE H REDMOND LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 07/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30375 NORTHWESTERN HWY, SUITE 200
FARMINGTON HILLS MI
48334
US

IV. Provider business mailing address

30375 NORTHWESTERN HWY SUITE #200
FARMINGTON HILLS MI
48334-3297
US

V. Phone/Fax

Practice location:
  • Phone: 248-254-3332
  • Fax: 248-254-3333
Mailing address:
  • Phone: 248-354-5760
  • Fax: 248-254-3333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberMR033134
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: