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NPI Code Detail

MEDICARE: STACI SULIMAN MSW

MEDICARE:   STACI  SULIMAN  MSW
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 Worker6801096745MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12-01284OTHERMICADC

General Provider Information

NPI Number : 1700294451
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACI SULIMAN MSW
Provider Business Mailing Address
First Line : 2052 WASHTENAW RD
Second Line :
City : YPSILANTI
State : MI
Zip : 48197-1706
Country : US
Telephone Number : 734-383-8394
Fax Number :
Provider Business Practice Location Address
First Line : 2052 WASHTENAW RD
Second Line :
City : YPSILANTI
State : MI
Zip : 48197-1706
Country : US
Telephone Number : 734-383-8394
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2014
Last Update Date : 07/12/2021

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Directions to “ STACI SULIMAN MSW” Practice Location

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