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NPI Code Detail

MEDICARE: MONIQUE ANN SAMANO LMSW

MEDICARE: MONIQUE ANN SAMANO 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
11041C0700XClinical Social Worker6801107146MI

General Provider Information

NPI Number : 1578022158
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONIQUE ANN SAMANO LMSW
Provider Business Mailing Address
First Line : 1 HERITAGE DR STE 261
Second Line :
City : SOUTHGATE
State : MI
Zip : 48195-2574
Country : US
Telephone Number : 734-778-0663
Fax Number :
Provider Business Practice Location Address
First Line : 1 HERITAGE DR STE 261
Second Line :
City : SOUTHGATE
State : MI
Zip : 48195-2574
Country : US
Telephone Number : 734-778-0663
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2019
Last Update Date : 07/26/2023

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Directions to “ MONIQUE ANN SAMANO LMSW” Practice Location

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