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General NPI Number Information
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NPI Number | 1982055943
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Entity Type | Individual
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Provider Name | MELISSA WUMMEL LMSW
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Gender | Female
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Dates
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Enumeration Date | 06/30/2016
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Last Update Date | 09/18/2024
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Provider Practice Location Address
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Address Line | 26522 VAN DYKE AVE
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City | CENTER LINE
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State | MI
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Zip | 48015-1221
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Country | US
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Telephone | 800-395-3223
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Fax |
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Provider Business Mailing Address
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Address Line | 935 W OAKRIDGE ST
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City | FERNDALE
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State | MI
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Zip | 48220-2754
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Country | US
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Telephone | 586-582-0500
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Fax | 586-834-2231
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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 | 6801099432
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License Number State | MI
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