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1174764054
TIMOTHY SAMUEL PREVOST
CLINTON TOWNSHIP, MI
NPI
1174764054
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
104100000X Social Worker
(Licence: MI 6802080110)
Enumeration Date
2009-03-23
Last Update Date
2009-03-23
Business Address
Mr. TIMOTHY SAMUEL PREVOST M.S.W.
16200 19 MILE RD
CLINTON TOWNSHIP, MI 48038-1103
Phone number: 586-263-8669
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Mailing Address
Mr. TIMOTHY SAMUEL PREVOST M.S.W.
22064 ELMWOOD AVE
EASTPOINTE, MI 48021-2114
Phone number: 586-808-8957
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