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General NPI Number Information
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NPI Number | 1477035475
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Entity Type | Individual
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Provider Name | WOORI SONG
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Gender | Female
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Dates
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Enumeration Date | 09/05/2018
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Last Update Date | 09/05/2018
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Provider Practice Location Address
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Address Line | 781 AVIS DR STE 200
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City | ANN ARBOR
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State | MI
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Zip | 48108-8959
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Country | US
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Telephone | 734-477-0135
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Fax |
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Provider Business Mailing Address
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Address Line | 2981 W CLARK RD APT 202
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City | YPSILANTI
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State | MI
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Zip | 48197-1132
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Country | US
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Telephone | 614-578-2412
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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 | 6801100755
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License Number State | MI
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