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NPI Code Detail

MEDICARE: TAMMY GREEN BSW, MHRM

MEDICARE: TAMMY GREEN BSW, MHRM
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1518361609
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMMY GREEN BSW, MHRM
Provider Business Mailing Address
First Line : 122 ELM ST
Second Line :
City : RIVER ROUGE
State : MI
Zip : 48218-1544
Country : US
Telephone Number : 313-412-3382
Fax Number :
Provider Business Practice Location Address
First Line : 19750 BURT RD
Second Line :
City : DETROIT
State : MI
Zip : 48219-2078
Country : US
Telephone Number : 313-531-2500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2014
Last Update Date : 02/05/2024

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Directions to “ TAMMY GREEN BSW, MHRM” Practice Location

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