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General NPI Number Information
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NPI Number | 1104222728
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Entity Type | Organization
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Legal Business Name | ELM ENTERPRISES, LLC
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Dates
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Enumeration Date | 11/10/2014
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Last Update Date | 11/10/2014
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Provider Practice Location Address
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Address Line | 1100 LUDINGTON ST SUITE 301A
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City | ESCANABA
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State | MI
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Zip | 49829-3542
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Country | US
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Telephone | 906-233-7477
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 LUDINGTON ST SUITE 301A
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City | ESCANABA
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State | MI
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Zip | 49829-3542
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Country | US
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Telephone | 906-233-7477
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | ELIZABETH MOBERG
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Credential | L.M.S.W.
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Telephone | 99062337477
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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 | 6801087072
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License Number State | MI
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