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General NPI Number Information
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NPI Number | 1225775117
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Entity Type | Individual
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Provider Name | SYDNEY RAE-SAIDOO NELSON LMSW, MA, TLLP
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Gender | Female
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Dates
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Enumeration Date | 05/12/2022
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 3940 RANCHERO DR STE 100
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City | ANN ARBOR
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State | MI
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Zip | 48108-3900
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Country | US
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Telephone | 734-222-9277
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Fax | 888-972-3797
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Provider Business Mailing Address
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Address Line | 3426 SEYMOUR RD
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City | SWARTZ CREEK
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State | MI
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Zip | 48473-9785
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Country | US
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Telephone | 810-569-2957
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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 | 6801098054
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301019592
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License Number State | MI
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