Provider Demographics
NPI:1497363758
Name:CALANDRINO, ANA H (LLMSW)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:H
Last Name:CALANDRINO
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:H
Other - Last Name:COLON DIAZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LLMSW
Mailing Address - Street 1:13556 MORTENVIEW DR
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-4705
Mailing Address - Country:US
Mailing Address - Phone:313-409-4172
Mailing Address - Fax:
Practice Address - Street 1:155 W CONGRESS ST STE 206
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48226-3200
Practice Address - Country:US
Practice Address - Phone:313-409-4172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801096668104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker