Healthcare Provider Details

I. General information

NPI: 1598933004
Provider Name (Legal Business Name): ISABELL E ROBLES MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2008
Last Update Date: 02/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8361 ELLIS RD
MILLINGTON MI
48746-9111
US

IV. Provider business mailing address

PO BOX 359
MILLINGTON MI
48746-0359
US

V. Phone/Fax

Practice location:
  • Phone: 989-871-6695
  • Fax: 989-871-3663
Mailing address:
  • Phone: 989-871-6695
  • Fax: 989-871-3663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801089409
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: