Provider Demographics
NPI:1518402825
Name:BALDWIN, MURIEL ANN (MS/MFT/ABA)
Entity Type:Individual
Prefix:
First Name:MURIEL
Middle Name:ANN
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:MS/MFT/ABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19268 TELEGRAPH RD
Mailing Address - Street 2:4
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-6327
Mailing Address - Country:US
Mailing Address - Phone:951-463-1555
Mailing Address - Fax:
Practice Address - Street 1:19268 TELEGRAPH RD
Practice Address - Street 2:4
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-6327
Practice Address - Country:US
Practice Address - Phone:951-463-1555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist