Provider Demographics
NPI:1518536481
Name:SIEWERT, CLAUDIA M
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:M
Last Name:SIEWERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 LITTLE LAKE DR # CONDO12
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-6207
Mailing Address - Country:US
Mailing Address - Phone:734-645-1915
Mailing Address - Fax:
Practice Address - Street 1:424 LITTLE LAKE DR # CONDO12
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-6207
Practice Address - Country:US
Practice Address - Phone:734-645-1915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401005531101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty