Healthcare Provider Details

I. General information

NPI: 1245383728
Provider Name (Legal Business Name): GEORGIANNA ALLUM LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9340 WAYNE ROMULUS HELP CTR
ROMULUS MI
48174
US

IV. Provider business mailing address

8623 N WAYNE STE 200 HEGIRA PROGRAMS INC
WESTLAND MI
48185
US

V. Phone/Fax

Practice location:
  • Phone: 734-942-2585
  • Fax: 734-942-7977
Mailing address:
  • Phone: 734-458-4601
  • Fax: 734-458-4611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: