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NPI Code Detail

MEDICARE: SHONDA ELIZABETH URBIEL LLMSW

MEDICARE:   SHONDA ELIZABETH URBIEL  LLMSW
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
1222Q00000XDevelopmental Therapist6801102908MI
21041C0700XClinical Social Worker6801102908MI

General Provider Information

NPI Number : 1447739594
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHONDA ELIZABETH URBIEL LLMSW
Provider Business Mailing Address
First Line : 11105 E JEFFERSON AVE
Second Line :
City : DETROIT
State : MI
Zip : 48214-3317
Country : US
Telephone Number : 734-695-0063
Fax Number :
Provider Business Practice Location Address
First Line : 11105 E JEFFERSON AVE
Second Line :
City : DETROIT
State : MI
Zip : 48214-3317
Country : US
Telephone Number : 734-695-0063
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2018
Last Update Date : 11/09/2023

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Directions to “ SHONDA ELIZABETH URBIEL LLMSW” Practice Location

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