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General NPI Number Information
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NPI Number | 1598173635
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Entity Type | Organization
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Legal Business Name | CENTER FOR WORK AND LIFE, LLC
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Dates
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Enumeration Date | 07/31/2014
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Last Update Date | 07/31/2014
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Provider Practice Location Address
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Address Line | 1919 PEPPERMILL WAY
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City | ANN ARBOR
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State | MI
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Zip | 48103-4531
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Country | US
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Telephone | 734-669-7202
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Fax | 888-581-9066
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Provider Business Mailing Address
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Address Line | 1919 PEPPERMILL WAY
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City | ANN ARBOR
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State | MI
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Zip | 48103-4531
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Country | US
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Telephone | 734-669-7202
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Fax | 888-581-9066
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Authorized Official
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Title or Position | CLINICAL SOCAIL WORKER
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Name | CHRISTINE M. WUCHERER
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Credential | LMSW, ACSW
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Telephone | 734-669-7202
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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 | 6801033752
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License Number State | MI
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