Provider Demographics
NPI:1891115192
Name:MADAJ, BARBARA
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:MADAJ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9212 SHARON HILLS CT
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48158-8694
Mailing Address - Country:US
Mailing Address - Phone:734-428-9333
Mailing Address - Fax:
Practice Address - Street 1:9212 SHARON HILLS CT
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48158-8694
Practice Address - Country:US
Practice Address - Phone:734-428-9333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-24
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010965331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical