Widenbaum, Amy Lynn
Widenbaum, Amy Lynn is an sole proprietor health care provider with primary practice located at 15645 Farmington Rd , Livonia MI 48154-2851. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Widenbaum, Amy Lynn can be contacted via phone (248) 568-9680.Contact Information
Primary practice address
15645 Farmington Rd
Livonia MI 48154-2851
Phone: (248) 568-9680
Fax: (734) 425-6212
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 6801066237 | Michigan |
Profile Details
| NPI number | 1558428276 |
|---|---|
| LBN Legal business name | Widenbaum, Amy Lynn |
| Credentials | MSW,LMSW,CSW,ACSW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 2nd, 2007 |
| Last updated | Jul 9th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558428276 | NPPES |
| Michigan | Other | 476528 | VALUE OPTIONS |
| Michigan | Other | 80-0-89-6782-0 | VALUE OPTIONS |
| Michigan | Other | 537109-000 | VALUE OPTIONS |
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