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NPI Code Detail

MEDICARE: BONNIE S DEFLON ACSW

MEDICARE: BONNIE S DEFLON ACSW
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 Worker6801018795MI

General Provider Information

NPI Number : 1639162050
Entity Type Code : Individual
Provider Name (Legal Business Name) : BONNIE S DEFLON ACSW
Provider Business Mailing Address
First Line : 28800 ORCHARD LAKE RD
Second Line : SUITE 250
City : FARMINGTON HILLS
State : MI
Zip : 48334-2981
Country : US
Telephone Number : 248-932-2500
Fax Number : 248-932-2506
Provider Business Practice Location Address
First Line : 28800 ORCHARD LAKE RD
Second Line : SUITE 250
City : FARMINGTON HILLS
State : MI
Zip : 48334-2981
Country : US
Telephone Number : 248-932-2500
Fax Number : 248-932-2506
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2005
Last Update Date : 07/08/2007

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Directions to “ BONNIE S DEFLON ACSW” Practice Location

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