Healthcare Provider Details

I. General information

NPI: 1831869700
Provider Name (Legal Business Name): HANNAH ZOMERMAAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2021
Last Update Date: 09/14/2021
Certification Date: 09/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2940 ELLSWORTH RD
YPSILANTI MI
48197-7406
US

IV. Provider business mailing address

2940 ELLSWORTH RD
YPSILANTI MI
48197-7406
US

V. Phone/Fax

Practice location:
  • Phone: 734-572-5777
  • Fax:
Mailing address:
  • Phone: 734-572-5777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801098256
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: