1790747194 NPI number — MRS. MARY ANN HILDA STIRLING-DOHERTY MA LLP LBSW

Table of content: MRS. MARY ANN HILDA STIRLING-DOHERTY MA LLP LBSW (NPI 1790747194)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790747194 NPI number — MRS. MARY ANN HILDA STIRLING-DOHERTY MA LLP LBSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STIRLING-DOHERTY
Provider First Name:
MARY ANN
Provider Middle Name:
HILDA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MA LLP LBSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STIRLING
Provider Other First Name:
MARY ANN
Provider Other Middle Name:
HILDA
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1790747194
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1860 MAYER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48063
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-329-4248
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1322 N RIVER RD
Provider Second Line Business Practice Location Address:
NORSERV GROUP LTD
Provider Business Practice Location Address City Name:
ST CLAIR
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48079
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-329-4798
Provider Business Practice Location Address Fax Number:
810-329-7303
Provider Enumeration Date:
04/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  6301003297 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 1041C0700X , with the licence number: 6801019862 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)





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