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General NPI Number Information
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NPI Number | 1043363922
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Entity Type | Individual
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Provider Name | ANDREA JOYCE ROWE LMSW
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Gender | Female
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 12/22/2020
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Provider Practice Location Address
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Address Line | 569 WILDWOOD AVE UNIT 4
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City | JACKSON
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State | MI
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Zip | 49201-1048
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Country | US
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Telephone | 517-883-2579
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Fax |
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Provider Business Mailing Address
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Address Line | 1690 BADGLEY RD
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City | JACKSON
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State | MI
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Zip | 49203-5233
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Country | US
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Telephone | 248-330-8789
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6801085310
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License Number State | MI
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