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General NPI Number Information
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NPI Number | 1063821650
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Entity Type | Organization
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Legal Business Name | MILLIE A. PATERSON, PLLC
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Dates
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Enumeration Date | 08/07/2014
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Last Update Date | 08/07/2014
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Provider Practice Location Address
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Address Line | 119 E SANILAC RD SUITE 8
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City | SANDUSKY
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State | MI
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Zip | 48471-1184
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Country | US
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Telephone | 810-689-4760
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Fax | 810-958-1295
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Provider Business Mailing Address
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Address Line | 3317 BLUE WATER DR
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City | BURTCHVILLE
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State | MI
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Zip | 48059-2505
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Country | US
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Telephone | 810-689-4760
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Fax | 810-958-1295
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Authorized Official
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Title or Position | OWNER
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Name | MILLIE A PATERSON
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Credential | LMSW, CAADC, MBA
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Telephone | 810-689-4760
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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 | 6801059994
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License Number State | MI
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