| Mi Healing Space | |
|
601 Abbot Rd Ste 103 East Lansing MI 48823-3366 | |
| (517) 574-4197 | |
| (517) 574-4201 |
| Full Name | Mi Healing Space |
|---|---|
| Speciality | Social Worker |
| Location | 601 Abbot Rd, East Lansing, Michigan |
| Authorized Official Name and Position | Patricia Wood (LMSW) |
| Authorized Official Contact | 5178622197 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mi Healing Space 601 Abbot Rd Ste 103 East Lansing MI 48823-3366 Ph: (517) 574-4197 | Mi Healing Space 601 Abbot Rd Ste 103 East Lansing MI 48823-3366 Ph: (517) 574-4197 |
| NPI Number | 1750735197 |
|---|---|
| Provider Enumeration Date | 04/22/2016 |
| Last Update Date | 05/03/2016 |
| Medicare PECOS PAC ID | 5496054918 |
|---|---|
| Medicare Enrollment ID | O20160504000750 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750735197 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | 6801095863 (Michigan) | Primary |
| Provider Name | Patricia I Wood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386034239 PECOS PAC ID: 6002115524 Enrollment ID: I20160504001063 |
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