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General NPI Number Information
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NPI Number | 1053907824
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Entity Type | Organization
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Legal Business Name | GERMASH THERAPEUTIC SERVICES, LLC
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Dates
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Enumeration Date | 12/16/2020
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Last Update Date | 05/08/2023
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Provider Practice Location Address
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Address Line | 800 N OLD WOODWARD AVE STE 210
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City | BIRMINGHAM
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State | MI
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Zip | 48009-3802
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Country | US
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Telephone | 734-719-1081
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Fax |
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Provider Business Mailing Address
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Address Line | 7821 DETROIT BLVD
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48323-1024
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Country | US
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Telephone | 734-719-1081
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Fax |
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Authorized Official
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Title or Position | CLINICAL THERAPIST
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Name | KATIE GERMASH-NEUBERT
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Credential | LMSW
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Telephone | 734-719-1081
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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 |
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License Number State |
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