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General NPI Number Information
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NPI Number | 1144769050
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Entity Type | Organization
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Legal Business Name | CAROL DIANE PSAILA
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Dates
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Enumeration Date | 02/13/2017
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Last Update Date | 02/13/2017
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Provider Practice Location Address
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Address Line | 3830 PACKARD ST STE 250
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City | ANN ARBOR
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State | MI
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Zip | 48108-2273
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Country | US
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Telephone | 734-358-3810
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Fax |
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Provider Business Mailing Address
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Address Line | 7618 BAY TREE DR
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City | YPSILANTI
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State | MI
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Zip | 48197-9572
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Country | US
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Telephone | 734-358-3810
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Fax |
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Authorized Official
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Title or Position | LMSW
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Name | CAROL D PSAILA
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Credential | LMSW
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Telephone | 734-358-3810
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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 | 6801077434
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License Number State | MI
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