Provider Demographics
NPI:1619085685
Name:BARLOW-SMITH, DAISY (MSW)
Entity Type:Individual
Prefix:MS
First Name:DAISY
Middle Name:
Last Name:BARLOW-SMITH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:DAISY
Other - Middle Name:LOU
Other - Last Name:BARLOW-SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LMSW
Mailing Address - Street 1:3303 WOODSTOCK DR
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48221-1339
Mailing Address - Country:US
Mailing Address - Phone:313-737-1887
Mailing Address - Fax:313-846-0236
Practice Address - Street 1:3303 WOODSTOCK DR
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48221-1339
Practice Address - Country:US
Practice Address - Phone:313-737-1887
Practice Address - Fax:313-846-0236
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801001392104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P35360Medicare PIN