Provider Demographics
NPI:1689722423
Name:RUBIN-MEILLER, ANITA (MSW)
Entity Type:Individual
Prefix:MS
First Name:ANITA
Middle Name:
Last Name:RUBIN-MEILLER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:ANITA
Other - Middle Name:SUE
Other - Last Name:RUBIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:1008 PAULINE BLVD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-5318
Mailing Address - Country:US
Mailing Address - Phone:734-332-0669
Mailing Address - Fax:
Practice Address - Street 1:514 E WILLIAM ST
Practice Address - Street 2:SUITE A
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-2446
Practice Address - Country:US
Practice Address - Phone:734-332-0669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010465641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI8008952600OtherBLUE CROSS
MI0N30930Medicare ID - Type UnspecifiedPROVIDER IDENTIFICATION