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General NPI Number Information
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NPI Number | 1689046732
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Entity Type | Organization
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Legal Business Name | DINA BALDWIN BERDY LLC
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Dates
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Enumeration Date | 10/28/2015
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Last Update Date | 10/28/2015
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Provider Practice Location Address
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Address Line | 575 E BIG BEAVER RD SUITE 260
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City | TROY
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State | MI
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Zip | 48083-1300
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Country | US
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Telephone | 248-561-6875
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Fax |
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Provider Business Mailing Address
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Address Line | 575 E BIG BEAVER RD SUITE 260
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City | TROY
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State | MI
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Zip | 48083-1300
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Country | US
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Telephone | 248-561-6875
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Fax |
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | MS. DINA BALDWIN BERDY
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Credential | LMSW
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Telephone | 248-561-6875
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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 | 6801084378
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License Number State | MI
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