Provider Demographics
NPI:1790192219
Name:GUZMAN, REBECA MARIA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:REBECA
Middle Name:MARIA
Last Name:GUZMAN
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 1:1400 WOODBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48207-3110
Mailing Address - Country:US
Mailing Address - Phone:313-309-9300
Mailing Address - Fax:313-309-6488
Practice Address - Street 1:1400 WOODBRIDGE ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48207-3110
Practice Address - Country:US
Practice Address - Phone:313-309-9300
Practice Address - Fax:313-309-6488
Is Sole Proprietor?:No
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical