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General NPI Number Information
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NPI Number | 1801957220
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Entity Type | Individual
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Provider Name | MARY ANN ASMUS LMSW ACSW
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Gender | Female
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 902 W FRONT ST
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City | TRAVERSE CITY
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State | MI
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Zip | 49684
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Country | US
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Telephone | 231-631-4038
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Fax | 231-946-6638
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Provider Business Mailing Address
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Address Line | 5836 DEER TRAIL DRIVE
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-8479
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Country | US
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Telephone | 231-275-5609
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Fax | 231-946-6638
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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 | 6801017592
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License Number State | MI
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