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NPI Code Detail

MEDICARE: AMY MARIE MNICH VALLERAND

MEDICARE:   AMY MARIE MNICH VALLERAND
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 Worker

General Provider Information

NPI Number : 1730635350
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY MARIE MNICH VALLERAND
Provider Business Mailing Address
First Line : 79 W ALEXANDRINE ST
Second Line :
City : DETROIT
State : MI
Zip : 48201-2015
Country : US
Telephone Number : 313-831-5535
Fax Number : 313-837-2608
Provider Business Practice Location Address
First Line : 79 W ALEXANDRINE ST
Second Line :
City : DETROIT
State : MI
Zip : 48201-2015
Country : US
Telephone Number : 313-831-5535
Fax Number : 313-837-2608
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2016
Last Update Date : 01/20/2026

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Directions to “ AMY MARIE MNICH VALLERAND ” Practice Location

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