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General NPI Number Information
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NPI Number | 1003922501
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Entity Type | Individual
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Provider Name | LISA INOUE MSW
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Gender | Female
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 01/23/2020
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Provider Practice Location Address
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Address Line | 5340 PLYMOUTH RD STE 210
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City | ANN ARBOR
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State | MI
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Zip | 48105-9559
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Country | US
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Telephone | 734-707-1013
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Fax | 734-345-1012
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Provider Business Mailing Address
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Address Line | 5331 PLYMOUTH RD
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City | ANN ARBOR
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State | MI
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Zip | 48105-9520
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Country | US
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Telephone | 734-996-9111
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Fax | 734-996-1950
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801081902
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License Number State | MI
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