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General NPI Number Information
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NPI Number | 1144346354
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Entity Type | Individual
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Provider Name | ELLEN O'BRYAN ROBEY LMSW
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Gender | Female
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 26184 OUTER DR
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City | LINCOLN PARK
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State | MI
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Zip | 48146-2084
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Country | US
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Telephone | 313-389-7579
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Fax |
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Provider Business Mailing Address
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Address Line | 4803 PRINCESS ST
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48125-1250
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Country | US
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Telephone | 313-292-9391
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Fax |
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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 | 6801057808
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License Number State | MI
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