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NPI Code Detail

MEDICARE: REBECCA WILSON-LONGLET LMSW

MEDICARE:   REBECCA  WILSON-LONGLET  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 Worker6801072436MI

General Provider Information

NPI Number : 1659308393
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA WILSON-LONGLET LMSW
Provider Business Mailing Address
First Line : 443 N STATE ST
Second Line :
City : CARO
State : MI
Zip : 48723-1539
Country : US
Telephone Number : 989-672-6160
Fax Number : 989-672-5649
Provider Business Practice Location Address
First Line : 126 WASHINGTON AVE
Second Line :
City : BAY CITY
State : MI
Zip : 48708-5846
Country : US
Telephone Number : 989-684-7977
Fax Number : 989-684-4331
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2006
Last Update Date : 01/11/2012

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Directions to “ REBECCA WILSON-LONGLET LMSW” Practice Location

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