Basic Information
| Provider Information | |||||||||
| NPI: | 1720155096 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RUMA | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 31500 SCHOOLCRAFT RD | ||||||||
| Address2: | STE 100 | ||||||||
| City: | LIVONIA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481501805 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7344229340 | ||||||||
| FaxNumber: | 7344229353 | ||||||||
| Practice Location | |||||||||
| Address1: | 31500 SCHOOLCRAFT RD | ||||||||
| Address2: | STE 100 | ||||||||
| City: | LIVONIA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481501805 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7344229340 | ||||||||
| FaxNumber: | 7344229353 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/29/2006 | ||||||||
| LastUpdateDate: | 06/16/2010 | ||||||||
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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 | 6801085373 | MI | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.