Basic Information
| Provider Information | |||||||||
| NPI: | 1063701548 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MORGAN | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | KAY | ||||||||
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| Credential: | BS,SW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 28715 SUMMERWOOD RD | ||||||||
| Address2: | |||||||||
| City: | FARMINGTON HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483343049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488552061 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1270 DORIS RD | ||||||||
| Address2: | |||||||||
| City: | AUBURN HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483262617 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2485351565 | ||||||||
| FaxNumber: | 2482769280 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2011 | ||||||||
| LastUpdateDate: | 04/05/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 6802072914 | MI | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.