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General NPI Number Information
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NPI Number | 1407148885
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Entity Type | Individual
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Provider Name | MEREL IRENE WADE LMSW
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Gender | Female
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Dates
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Enumeration Date | 05/04/2011
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Last Update Date | 05/04/2011
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Provider Practice Location Address
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Address Line | 6330 DEXTER ST
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City | ROMULUS
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State | MI
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Zip | 48174-1832
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Country | US
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Telephone | 734-595-9105
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Fax | 734-595-9107
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Provider Business Mailing Address
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Address Line | 6330 DEXTER ST.
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City | ROMULUS
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State | MI
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Zip | 48174
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Country | US
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Telephone | 734-595-9105
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Fax | 734-595-9107
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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 | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 6801062423
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License Number State | MI
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