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NPI Code Detail

MEDICARE: JANNA MARINKO LLMSW

MEDICARE: JANNA MARINKO 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 WorkerL2230615MI

General Provider Information

NPI Number : 1932461050
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANNA MARINKO LLMSW
Provider Business Mailing Address
First Line : 1353 HAZEL ST
Second Line :
City : BIRMINGHAM
State : MI
Zip : 48009-6801
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 30000 HIVELEY ST
Second Line :
City : INKSTER
State : MI
Zip : 48141-1089
Country : US
Telephone Number : 248-763-9253
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2012
Last Update Date : 12/15/2014

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Directions to “ JANNA MARINKO LLMSW” Practice Location

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