Healthcare Provider Details

I. General information

NPI: 1194899294
Provider Name (Legal Business Name): HANA BAUDYS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 08/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6195 MILLER RD. STE A
SWARTZ CREEK MI
48473
US

IV. Provider business mailing address

6195 MILLER RD. STE A
SWARTZ CREEK MI
48473
US

V. Phone/Fax

Practice location:
  • Phone: 810-630-1152
  • Fax: 810-630-9107
Mailing address:
  • Phone: 810-630-1152
  • Fax: 810-630-9107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801058579
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: