Healthcare Provider Details

I. General information

NPI: 1346319407
Provider Name (Legal Business Name): DONNA FAYE SEFTON LBSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 E SANILAC RD SUITE ONE
SANDUSKY MI
48471-1383
US

IV. Provider business mailing address

331 N STATE RD
CARSONVILLE MI
48419-9742
US

V. Phone/Fax

Practice location:
  • Phone: 810-648-4450
  • Fax: 810-648-5833
Mailing address:
  • Phone: 810-622-8515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6802046887
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: