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General NPI Number Information
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NPI Number | 1609378892
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Entity Type | Individual
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Provider Name | BRIANNA A KAMMER-WALSH LMSW
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Gender | Female
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Dates
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Enumeration Date | 03/02/2018
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Last Update Date | 03/02/2018
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Provider Practice Location Address
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Address Line | 950 W AVON RD STE 3
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-2761
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Country | US
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Telephone | 248-656-5003
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Fax |
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Provider Business Mailing Address
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Address Line | 77925 PINNOO RD
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City | RICHMOND
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State | MI
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Zip | 48062-2700
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Country | US
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Telephone | 810-335-3163
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801097091
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License Number State | MI
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