Provider Demographics
NPI:1649576273
Name:BYLES, MAURICE (MSW)
Entity Type:Individual
Prefix:
First Name:MAURICE
Middle Name:
Last Name:BYLES
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-2127
Mailing Address - Country:US
Mailing Address - Phone:517-902-9541
Mailing Address - Fax:866-223-1175
Practice Address - Street 1:2376 WILDWOOD TRL
Practice Address - Street 2:
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176-1657
Practice Address - Country:US
Practice Address - Phone:734-944-3446
Practice Address - Fax:866-223-1175
Is Sole Proprietor?:No
Enumeration Date:2011-01-29
Last Update Date:2011-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010927581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical