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General NPI Number Information
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NPI Number | 1427346170
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Entity Type | Organization
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Legal Business Name | C.W. ENTERPRISE LLC
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Dates
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Enumeration Date | 07/15/2011
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Last Update Date | 03/15/2019
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Provider Practice Location Address
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Address Line | 32743 23 MILE RD STE 130
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City | CHESTERFIELD
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State | MI
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Zip | 48047-2082
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Country | US
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Telephone | 586-273-7095
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Fax | 586-273-7196
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Provider Business Mailing Address
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Address Line | 32743 23 MILE RD STE 130
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City | CHESTERFIELD
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State | MI
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Zip | 48047-2082
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Country | US
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Telephone | 586-273-7095
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Fax | 586-273-7196
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. YOLANDA J DOBBYN
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Credential |
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Telephone | 586-273-7095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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