MEDICARE: SARAH FARRELL-BELASCO

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	6801088898	MI

General Provider Information

NPI Number	:	1396141388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH FARRELL-BELASCO

Provider Business Mailing Address
First Line	:	120 PARSONS ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48201-2002
Country	:	US
Telephone Number	:	313-344-6228
Fax Number	:	313-338-3098

Provider Business Practice Location Address
First Line	:	120 PARSONS ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48201-2002
Country	:	US
Telephone Number	:	313-344-6228
Fax Number	:	313-338-3098

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

Provider Enumeration Date	:	11/18/2014
Last Update Date	:	11/18/2014

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Directions to “ SARAH FARRELL-BELASCO ” Practice Location

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