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General NPI Number Information
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NPI Number | 1831209626
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Entity Type | Individual
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Provider Name | ROBERTA J BIDWELL LMSW
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3521 STATE ST
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City | SAGINAW
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State | MI
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Zip | 48602-3267
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Country | US
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Telephone | 989-791-3756
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Fax | 775-361-1240
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Provider Business Mailing Address
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Address Line | 15 SOUTHLAWN CT
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City | SAGINAW
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State | MI
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Zip | 48602-1817
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Country | US
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Telephone | 989-792-0226
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Fax | 775-361-1240
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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 | 6801018670
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License Number State | MI
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