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General NPI Number Information
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NPI Number | 1063711679
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Entity Type | Individual
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Provider Name | LAURA ZEITLIN MSW
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Gender | Female
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Dates
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Enumeration Date | 03/22/2011
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Last Update Date | 03/22/2011
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Provider Practice Location Address
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Address Line | 1500 E. MEDICAL CENTER DR D2202 MEDICAL PROFESSIONAL BLD
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City | ANN ARBOR
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State | MI
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Zip | 48109-5718
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Country | US
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Telephone | 734-936-7090
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Fax | 734-763-9950
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Provider Business Mailing Address
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Address Line | 1500 E. MEDICAL CENTER DR D2202 MEDICAL PROFESSIONAL BLD
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City | ANN ARBOR
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State | MI
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Zip | 48109-5718
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Country | US
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Telephone | 734-936-7090
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Fax | 734-763-9950
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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 | 6801072512
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License Number State | MI
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