Doctor Name: | ROSETTA LOUISE BAILEY |
NPI Number: | 1083085781 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SSW |
License Number: | 6801066179 |
Business Practice Address: | 28050 Southfield Rd Lathrup Village, MI - 480762832 |
Business Phone Number: | 3137022300 |
Business Fax Number: | 3136939527 |
Mailing Address: | 18701 Grand River Ave # 205, DETROIT |
State: | MI |
Postal Code: | 482232214 |
Phone Number: | 3137022300 |
Fax Number: | 3136939527 |
NPI Enumeration Date: | 10/07/2015 |
NPI Last Update Date: | 10/07/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 6801066179 |
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 |