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General NPI Number Information
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NPI Number | 1841682168
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Entity Type | Individual
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Provider Name | RACHEL CUSHMAN L.L.M.S.W
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Gender | Female
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Dates
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Enumeration Date | 02/24/2015
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Last Update Date | 04/25/2019
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Provider Practice Location Address
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Address Line | 9603 E PICKWICK CIR
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City | TAYLOR
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State | MI
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Zip | 48180-3858
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Country | US
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Telephone | 313-310-2303
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Fax |
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Provider Business Mailing Address
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Address Line | 9603 E PICKWICK CIR
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City | TAYLOR
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State | MI
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Zip | 48180-3858
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Country | US
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Telephone | 313-310-2303
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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 | 247200000X
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Taxonomy Name | Other Technician
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License Number | C255730594346
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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