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General NPI Number Information
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NPI Number | 1396933040
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Entity Type | Individual
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Provider Name | MICHELE ROSE GARRICK LSW
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Gender | Female
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 10/09/2007
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Provider Practice Location Address
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Address Line | 416 COLUMBUS AVE
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City | SANDUSKY
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State | OH
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Zip | 44870-2753
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Country | US
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Telephone | 419-627-1647
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Fax |
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Provider Business Mailing Address
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Address Line | 2803 AKRON RD
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City | WOOSTER
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State | OH
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Zip | 44691-7904
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Country | US
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Telephone |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | S0009569
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License Number State | OH
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