Madison Marie Lauder
Social Worker, Clinical in Southgate, MI. Individual provider (NPI-1).
NPI number1194383000
StatusActive
Last updated in NPPESJun 11, 2019
Details
- NPI
- 1194383000
- Entity type
- Individual (NPI-1)
- Name
- Madison Marie Lauder
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 5, 2019
- Last updated
- Jun 11, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | – | – | Yes |
Practice location
13101 Allen RdSouthgate, MI 48195-2216
Phone 734-785-7700
Mailing address
22160 Fairfax StTaylor, MI 48180-2772
Phone 313-850-2469
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