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General NPI Number Information
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NPI Number | 1093864803
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Entity Type | Organization
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Legal Business Name | CHIMERICAL INC
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4511 MILLER RD
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City | FLINT
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State | MI
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Zip | 48507-1107
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Country | US
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Telephone | 810-733-8500
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Fax | 810-733-8500
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Provider Business Mailing Address
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Address Line | 4511 MILLER RD
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City | FLINT
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State | MI
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Zip | 48507-1107
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Country | US
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Telephone | 810-733-8500
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Fax | 810-733-8500
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Authorized Official
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Title or Position | THERAPIST
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Name | MS. MARCH WALKER
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Credential | ACSW,LMSW,BCD
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Telephone | 810-733-8500
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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 | 6801018404
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License Number State | MI
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