Basic Information
Provider Information
NPI: 1467647206
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BRITT
FirstName: DELPHINE
MiddleName: GINZELL
NamePrefix: MS.
NameSuffix:  
Credential: LBSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 13101 ALLEN RD
Address2: SUITE 400
City: SOUTHGATE
State: MI
PostalCode: 481952216
CountryCode: US
TelephoneNumber: 7347857700
FaxNumber: 7342871661
Practice Location
Address1: 13101 ALLEN RD
Address2: SUITE 400
City: SOUTHGATE
State: MI
PostalCode: 481952216
CountryCode: US
TelephoneNumber: 7347857700
FaxNumber: 7342871661
Other Information
ProviderEnumerationDate: 09/13/2007
LastUpdateDate: 09/13/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000X6802076478MIY Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


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