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NPI Code Detail

MEDICARE: LORRAINE WAGNER STEELE

MEDICARE: LORRAINE WAGNER STEELE
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
1101Y00000XCounselor6401006164MI
2104100000XSocial Worker6801014722MI

General Provider Information

NPI Number : 1871552463
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORRAINE WAGNER STEELE
Provider Business Mailing Address
First Line : 44131 HANFORD RD
Second Line :
City : CANTON
State : MI
Zip : 48187-2815
Country : US
Telephone Number : 734-414-0129
Fax Number :
Provider Business Practice Location Address
First Line : 2051 W GRAND BLVD
Second Line :
City : DETROIT
State : MI
Zip : 48208-1105
Country : US
Telephone Number : 313-961-5431
Fax Number : 313-961-3324
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2006
Last Update Date : 04/28/2011

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Directions to “ LORRAINE WAGNER STEELE ” Practice Location

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