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General NPI Number Information
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NPI Number | 1881874659
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Entity Type | Individual
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Provider Name | ALETA MARIE RUNEY LMSW, CCM, ACSW
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Gender | Female
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Dates
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Enumeration Date | 11/09/2007
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Last Update Date | 08/17/2011
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Provider Practice Location Address
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Address Line | 4646 JOHN R ST MENTAL HEALTH- HCHV
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City | DETROIT
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State | MI
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Zip | 48201-1916
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Country | US
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Telephone | 313-576-3611
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Fax | 313-576-1074
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Provider Business Mailing Address
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Address Line | 22343 KINYON ST UNIT 12
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City | TAYLOR
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State | MI
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Zip | 48180-3692
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Country | US
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Telephone | 313-768-5574
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Fax | 313-576-1074
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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 | 6801064768
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License Number State | MI
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