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NPI Code Detail

MEDICARE: MARY REWERS LPC

MEDICARE: MARY REWERS LPC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1922106228
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY REWERS LPC
Provider Business Mailing Address
First Line : 42633 GARFIELD RD
Second Line :
City : CLINTON TWP
State : MI
Zip : 48038-5033
Country : US
Telephone Number : 586-226-7007
Fax Number : 586-226-7003
Provider Business Practice Location Address
First Line : 42633 GARFIELD RD
Second Line :
City : CLINTON TWP
State : MI
Zip : 48038-5033
Country : US
Telephone Number : 586-226-7007
Fax Number : 586-226-7003
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 07/08/2007

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Directions to “ MARY REWERS LPC” Practice Location

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