Shirley Bouza, LMSW

Individual provider Active NPI Clinical Social Worker · Caro, MI

NPI 1285745828 · NPPES record last updated Oct 30, 2024

Key facts

NPI
1285745828
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
6801086600 (MI)
Practice address
1332 Prospect Ave
Caro, MI 48723-9288
Phone
(989) 673-6191
Fax
(989) 672-3443
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
6801086600MIMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801086600 MI Yes

Addresses

Primary practice location

1332 Prospect Ave
Caro, MI 48723-9288

Mailing address

323 N State St
PO Box 239
Caro, MI 48723-1537
Phone (989) 673-6191

Other providers in Caro, MI

All providers in Caro, MI · Clinical Social Worker in Michigan

Sources for this page

Verify at the official NPI Registry.