Healthcare Provider Details

I. General information

NPI: 1164642716
Provider Name (Legal Business Name): SUZANNE PINSON LBSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 02/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9315 TELEGRAPH RD
REDFORD MI
48239-1260
US

IV. Provider business mailing address

9690 GRAMS RD
MAYBEE MI
48159-9769
US

V. Phone/Fax

Practice location:
  • Phone: 313-450-4500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6802083601
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: