Provider Demographics
NPI:1376236711
Name:MACH, WUOI
Entity Type:Individual
Prefix:
First Name:WUOI
Middle Name:
Last Name:MACH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 W HOWELL ROAD
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:MI
Mailing Address - Zip Code:48854
Mailing Address - Country:US
Mailing Address - Phone:517-367-0670
Mailing Address - Fax:517-367-0681
Practice Address - Street 1:2950 W HOWELL ROAD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:MI
Practice Address - Zip Code:48854
Practice Address - Country:US
Practice Address - Phone:517-367-0670
Practice Address - Fax:517-367-0681
Is Sole Proprietor?:No
Enumeration Date:2023-05-31
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851116293104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker