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NPI Code Detail

MEDICARE: JANNIFER KIM MAINO LMSW

MEDICARE: JANNIFER KIM MAINO LMSW
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 Worker6801105433MI

General Provider Information

NPI Number : 1558004077
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANNIFER KIM MAINO LMSW
Provider Business Mailing Address
First Line : 2600 N DETTMAN RD
Second Line :
City : JACKSON
State : MI
Zip : 49201-8837
Country : US
Telephone Number : 517-917-2352
Fax Number :
Provider Business Practice Location Address
First Line : 2825 WIENEKE RD
Second Line :
City : SAGINAW
State : MI
Zip : 48603-2600
Country : US
Telephone Number : 989-262-7385
Fax Number : 989-652-3916
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2022
Last Update Date : 04/14/2022

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Directions to “ JANNIFER KIM MAINO LMSW” Practice Location

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