Organization Name: | BERNADETTE DI CARLO PLLC |
NPI Number: | 1124398557 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BERNADETTE DI CARLO (PROVIDER) |
Mailing Address: | 417 S Lafayette St Suite112 South Lyon |
State: | MI US |
Postal Code: | 481781458 |
Phone Number: | 7348460793 |
Fax Number: | |
NPI Enumeration Date: | 01/02/2012 |
NPI Last Update Date: | 01/02/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 6801085686 |
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 |