Provider Demographics
NPI:1598244014
Name:AYOTTE, RORY KRISTEN (LMSW)
Entity Type:Individual
Prefix:
First Name:RORY
Middle Name:KRISTEN
Last Name:AYOTTE
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 1:36300 GIERK ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:MI
Mailing Address - Zip Code:48062-1635
Mailing Address - Country:US
Mailing Address - Phone:810-650-0794
Mailing Address - Fax:
Practice Address - Street 1:36300 GIERK ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:MI
Practice Address - Zip Code:48062-1635
Practice Address - Country:US
Practice Address - Phone:810-650-0794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010913321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical