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General NPI Number Information
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NPI Number | 1811550437
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Entity Type | Individual
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Provider Name | KATHARINE ELISE HAZARD NEUBURGER LMSW
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Gender | Female
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Dates
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Enumeration Date | 04/18/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 23965 NOVI RD STE 110
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City | NOVI
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State | MI
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Zip | 48375-3232
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Country | US
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Telephone | 248-344-7420
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Fax | 248-344-7423
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Provider Business Mailing Address
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Address Line | 1723 RUSTIC RIDGE RD
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City | CANTON
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State | MI
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Zip | 48188-1250
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Country | US
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Telephone | 248-390-9768
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6801103868
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License Number State | MI
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