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NPI Code Detail

MEDICARE: MS. VIVIAN YVONNE JONES LLMSW

MEDICARE: MS. VIVIAN YVONNE JONES LLMSW
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 Worker6801102847MI

General Provider Information

NPI Number : 1811481724
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. VIVIAN YVONNE JONES LLMSW
Provider Business Mailing Address
First Line : 80 SEWARD ST APT B4
Second Line :
City : DETROIT
State : MI
Zip : 48202-4432
Country : US
Telephone Number : 313-879-8209
Fax Number :
Provider Business Practice Location Address
First Line : 570 KIRTS BLVD STE 231
Second Line :
City : TROY
State : MI
Zip : 48084-4156
Country : US
Telephone Number : 248-928-0111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2018
Last Update Date : 06/15/2018

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