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NPI Code Detail

MEDICARE: MRS. CAROL JANE DISKIN MSW

MEDICARE:  MRS. CAROL JANE DISKIN  MSW
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 Worker6801062057MI

General Provider Information

NPI Number : 1306087168
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CAROL JANE DISKIN MSW
Provider Business Mailing Address
First Line : 2296 GARLAND ST
Second Line :
City : SYLVAN LAKE
State : MI
Zip : 48320-1618
Country : US
Telephone Number : 248-854-8627
Fax Number :
Provider Business Practice Location Address
First Line : 2296 GARLAND ST
Second Line :
City : SYLVAN LAKE
State : MI
Zip : 48320-1618
Country : US
Telephone Number : 248-854-8627
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2009
Last Update Date : 03/09/2009

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Directions to “ MRS. CAROL JANE DISKIN MSW” Practice Location

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