Healthcare Provider Details

I. General information

NPI: 1255481479
Provider Name (Legal Business Name): MAREEN ALLYN-SNYDER STEVENS MSW, LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15370 LEVAN RD SUITE 2
LIVONIA MI
48154-1903
US

IV. Provider business mailing address

30960 RAYBURN ST
LIVONIA MI
48154-3298
US

V. Phone/Fax

Practice location:
  • Phone: 734-744-0170
  • Fax: 734-744-0171
Mailing address:
  • Phone: 734-261-9456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801059436
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: