| Gualdoni Therapeutic & Consultative Services Llc | |
|
8240 Embury Rd Ste 1 Grand Blanc MI 48439-7113 | |
| (810) 691-4196 | |
| Not Available |
| Full Name | Gualdoni Therapeutic & Consultative Services Llc |
|---|---|
| Speciality | Social Worker |
| Location | 8240 Embury Rd Ste 1, Grand Blanc, Michigan |
| Authorized Official Name and Position | Mary Beth Houpt (CREDENTIALING) |
| Authorized Official Contact | 5176769797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gualdoni Therapeutic & Consultative Services Llc Po Box 10 Mason MI 48854-0010 Ph: () - | Gualdoni Therapeutic & Consultative Services Llc 8240 Embury Rd Ste 1 Grand Blanc MI 48439-7113 Ph: (810) 691-4196 |
| NPI Number | 1427731967 |
|---|---|
| Provider Enumeration Date | 08/10/2023 |
| Last Update Date | 08/10/2023 |
| Certification Date | 08/10/2023 |
| Medicare PECOS PAC ID | 1456713635 |
|---|---|
| Medicare Enrollment ID | O20230821001422 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427731967 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Laura Kay Gualdoni |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649822776 PECOS PAC ID: 3274995451 Enrollment ID: I20230821001568 |
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