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NPI Code Detail

MEDICARE: MRS. ANGELA PATRICIA - GALEANO CARLSON CPSS/ CHW

MEDICARE:  MRS. ANGELA PATRICIA - GALEANO CARLSON  CPSS/ CHW
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
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1740544550
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANGELA PATRICIA - GALEANO CARLSON CPSS/ CHW
Provider Business Mailing Address
First Line : 23910 OAK ST
Second Line :
City : DEARBORN
State : MI
Zip : 48128-2202
Country : US
Telephone Number : 313-562-8230
Fax Number :
Provider Business Practice Location Address
First Line : 23910 OAK ST
Second Line :
City : DEARBORN
State : MI
Zip : 48128-2202
Country : US
Telephone Number : 313-562-8230
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2012
Last Update Date : 03/11/2024

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Directions to “ MRS. ANGELA PATRICIA - GALEANO CARLSON CPSS/ CHW” Practice Location

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