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General NPI Number Information
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NPI Number | 1790585404
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Entity Type | Individual
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Provider Name | WENDY MICHELLE DAVIS BSW, LLMSW
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Gender | Female
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Dates
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Enumeration Date | 03/13/2025
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 22511 TELEGRAPH RD STE 222
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City | SOUTHFIELD
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State | MI
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Zip | 48033-4108
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Country | US
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Telephone | 248-598-2297
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Fax |
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Provider Business Mailing Address
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Address Line | 110 EASTERN ST
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City | INKSTER
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State | MI
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Zip | 48141-1187
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Country | US
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Telephone | 313-570-7088
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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 | 6851115599
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License Number State | MI
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