MEDICARE: REMI SPICER SCHLOFF 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
1	104100000X	Social Worker	6801078741	MI

General Provider Information

NPI Number	:	1255438230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REMI SPICER SCHLOFF LMSW

Provider Business Mailing Address
First Line	:	1061 WASHINGTON AVE
Second Line	:
City	:	HOLLAND
State	:	MI
Zip	:	49423-5216
Country	:	US
Telephone Number	:	616-617-1188
Fax Number	:	616-393-8525

Provider Business Practice Location Address
First Line	:	1061 WASHINGTON AVE
Second Line	:
City	:	HOLLAND
State	:	MI
Zip	:	49423-5216
Country	:	US
Telephone Number	:	616-617-1188
Fax Number	:	616-393-8525

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	09/18/2019

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