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General NPI Number Information
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NPI Number | 1861720427
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Entity Type | Individual
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Provider Name | JAMIE RYAN LASKASK LLMSW
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Gender | Female
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Dates
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Enumeration Date | 11/19/2009
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Last Update Date | 11/19/2009
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Provider Practice Location Address
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Address Line | 1001 S RAISINVILLE RD
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City | MONROE
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State | MI
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Zip | 48161-9754
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Country | US
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Telephone | 734-384-8949
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Fax | 734-243-0145
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Provider Business Mailing Address
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Address Line | 40 S BIGGS ST
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City | BELLEVILLE
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State | MI
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Zip | 48111-3615
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Country | US
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Telephone | 734-384-0076
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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 | 6801087026
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License Number State | MI
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