Travis John Vanderlist LMSW

NPI 1003155219 - Social Worker - 1041C0700X

NPI Details
NPI 1003155219
Gender Male
Enumeration Date 02/07/2013
Last Updated 02/07/2013
Entity Type Individual
Active Over 4 years ago
Practice Location
1500 WEISS ST
SAGINAW MI, 48602-5251, US
Phone (989) 497-2500
Fax (989) 321-4922
Business Location
311 OXFORD RD
EAST LANSING MI, 48823-2628, US
Phone (517) 303-3969
Fax
Toxanomy
Taxonomy Code 1041C0700X
License State Michigan
License Number 6801090423
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According to our database, Mr. Travis John Vanderlist LMSW NPI is 1003155219, taxonomy code is 1041C0700X and license number is 6801090423, license state is located at Michigan. Travis John Vanderlist LMSW physically located at 1500 Weiss St, Saginaw MI, 48602-5251. NPI Number Travis John Vanderlist LMSW has the Individual type.

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1003155219 NPI number is provided on an as is basis without warranty of any kind. 1003155219 is maintained by the National Plan & Provider Enumeration System. The contents of Travis John Vanderlist LMSW are for informational purposes only.