| Doctor Name: | BETHANY PICCINATO |
| NPI Number: | 1013218148 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMSW |
| License Number: | 6801090054 |
| Business Practice Address: | 269 Summit Dr Waterford, MI - 483283364 |
| Business Phone Number: | 2487063450 |
| Business Fax Number: | |
| Mailing Address: | 2399 E Walton Blvd, AUBURN HILLS |
| State: | MI |
| Postal Code: | 483261955 |
| Phone Number: | 2484756400 |
| Fax Number: | |
| NPI Enumeration Date: | 11/05/2010 |
| NPI Last Update Date: | 11/05/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 6801090054 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |