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NPI Code Detail

MEDICARE: MS. ABRA ELISABETH KITEI LMSW

MEDICARE: MS. ABRA ELISABETH KITEI LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker6801102303MI

General Provider Information

NPI Number : 1043385297
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ABRA ELISABETH KITEI LMSW
Provider Business Mailing Address
First Line : 1491 CHAPIN AVE
Second Line :
City : BIRMINGHAM
State : MI
Zip : 48009-2000
Country : US
Telephone Number : 312-560-9104
Fax Number :
Provider Business Practice Location Address
First Line : 2075 W BIG BEAVER RD STE 520
Second Line :
City : TROY
State : MI
Zip : 48084-3442
Country : US
Telephone Number : 248-282-2321
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2006
Last Update Date : 07/24/2019

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