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General NPI Number Information
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NPI Number | 1558565283
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Entity Type | Individual
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Provider Name | SABITA RAO TUMMALA LMSW, ACSW, BCD
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Gender | Female
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1170 ROBERT T LONGWAY BLVD
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City | FLINT
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State | MI
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Zip | 48503-1851
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Country | US
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Telephone | 810-767-4014
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Fax | 810-767-0020
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Provider Business Mailing Address
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Address Line | 1240 WOODKREST DR
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City | FLINT
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State | MI
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Zip | 48532-2249
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Country | US
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Telephone | 810-733-8673
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Fax | 810-767-0020
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801063882
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License Number State | MI
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