Doctor Name: | BARRY CRAIG EITEL |
NPI Number: | 1225066152 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.S.W |
License Number: | 6801063087 |
Business Practice Address: | 4315 Piehl Rd Ottawa Lake, MI - 492678710 |
Business Phone Number: | 4192605552 |
Business Fax Number: | |
Mailing Address: | 4315 Piehl Rd, OTTAWA LAKE |
State: | MI |
Postal Code: | 492678710 |
Phone Number: | 4192605552 |
Fax Number: | |
NPI Enumeration Date: | 06/29/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 6801063087 |
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 |