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NPI Code Detail

MEDICARE: MS. AMY LYNN RENDON LMSW

MEDICARE:  MS. AMY LYNN RENDON  LMSW
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 Worker6801084493MI

General Provider Information

NPI Number : 1881720266
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AMY LYNN RENDON LMSW
Provider Business Mailing Address
First Line : 555 TOWNER ST
Second Line : PO BOX 915
City : YPSILANTI
State : MI
Zip : 48198-5752
Country : US
Telephone Number : 734-544-3000
Fax Number : 734-544-6732
Provider Business Practice Location Address
First Line : 3174 PACKARD ST
Second Line :
City : ANN ARBOR
State : MI
Zip : 48108-1947
Country : US
Telephone Number : 734-368-5911
Fax Number : 734-971-2487
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2007
Last Update Date : 07/08/2007

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Directions to “ MS. AMY LYNN RENDON LMSW” Practice Location

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