Healthcare Provider Details

I. General information

NPI: 1124940424
Provider Name (Legal Business Name): JAN PATRICE BICE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1176 S MAIN ST
PLYMOUTH MI
48170-2252
US

IV. Provider business mailing address

1176 S MAIN ST
PLYMOUTH MI
48170-2252
US

V. Phone/Fax

Practice location:
  • Phone: 734-564-4234
  • Fax:
Mailing address:
  • Phone: 734-564-4234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801084260
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: