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General NPI Number Information
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NPI Number | 1326654187
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Entity Type | Organization
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Legal Business Name | THERESA M BATEMAN LMSW
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Dates
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Enumeration Date | 09/17/2020
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Last Update Date | 09/17/2020
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Provider Practice Location Address
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Address Line | 2265 LIVERNOIS RD STE 260
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City | TROY
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State | MI
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Zip | 48083-1639
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Country | US
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Telephone | 313-784-0017
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Fax | 517-920-4702
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Provider Business Mailing Address
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Address Line | 5166 DAYTON DR
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City | TROY
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State | MI
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Zip | 48085-4051
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Country | US
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Telephone | 313-784-0017
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Fax | 517-920-4702
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Authorized Official
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Title or Position | LMSW
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Name | THERESA M BATEMAN
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Credential | LMSW
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Telephone | 313-784-0017
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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 |
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License Number State |
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