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General NPI Number Information
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NPI Number | 1356731145
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Entity Type | Organization
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Legal Business Name | BLUE THUNDERBIRD WOMAN COUNSELING PLC
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Dates
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Enumeration Date | 01/31/2015
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Last Update Date | 01/31/2015
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Provider Practice Location Address
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Address Line | 2121 VIRGINIA DR
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City | TROY
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State | MI
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Zip | 48083-2544
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Country | US
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Telephone | 248-703-9812
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Fax |
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Provider Business Mailing Address
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Address Line | 2121 VIRGINIA DR
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City | TROY
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State | MI
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Zip | 48083-2544
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Country | US
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Telephone | 248-703-9812
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | REGINA A ZAPINSKI
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Credential | LMSW
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Telephone | 248-703-9812
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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 | 6801091034
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License Number State | MI
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