Basic Information
| Provider Information | |||||||||
| NPI: | 1043376619 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SLOAN | ||||||||
| FirstName: | SUSAN | ||||||||
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| Credential: | MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7915 MUNGER RD | ||||||||
| Address2: | |||||||||
| City: | YPSILANTI | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481979324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7344341474 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6223 N CANTON CENTER RD | ||||||||
| Address2: | |||||||||
| City: | CANTON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481872696 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7347371200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 6801057500 | MI | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.