Provider Demographics
NPI:1184826406
Name:TUNSTULL, BARBARA RUBY (LMSW)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:RUBY
Last Name:TUNSTULL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16866 AVON AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-4143
Mailing Address - Country:US
Mailing Address - Phone:313-534-7378
Mailing Address - Fax:313-534-7378
Practice Address - Street 1:16866 AVON AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-4143
Practice Address - Country:US
Practice Address - Phone:313-534-7378
Practice Address - Fax:313-534-7378
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010206321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical