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NPI Code Detail

MEDICARE: MRS. GEORGIA RUTH CRAWFORD-CAMBELL C.S.W., M.S.W., M. A

MEDICARE:  MRS. GEORGIA RUTH CRAWFORD-CAMBELL  C.S.W., M.S.W., M. A
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 Worker6801057431MI

General Provider Information

NPI Number : 1477845238
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. GEORGIA RUTH CRAWFORD-CAMBELL C.S.W., M.S.W., M. A
Provider Business Mailing Address
First Line : 18401 SUSSEX ST
Second Line :
City : DETROIT
State : MI
Zip : 48235-2837
Country : US
Telephone Number : 313-272-6232
Fax Number :
Provider Business Practice Location Address
First Line : 2265 W GRAND BLVD
Second Line :
City : DETROIT
State : MI
Zip : 48208-1168
Country : US
Telephone Number : 313-272-6232
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2011
Last Update Date : 05/11/2011

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