Healthcare Provider Details

I. General information

NPI: 1679656698
Provider Name (Legal Business Name): JANET D LOESCHE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4736 E MI 36
PINCKNEY MI
48169-9383
US

IV. Provider business mailing address

6210 COWELL RD
BRIGHTON MI
48116-5113
US

V. Phone/Fax

Practice location:
  • Phone: 810-231-9591
  • Fax: 810-231-9522
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801035150
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: