Provider Demographics
NPI:1962845578
Name:LAWSON CHUKWUDI, PATRICIA ANN (LBSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:LAWSON CHUKWUDI
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:ANN
Other - Last Name:CHUKWUDI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LBSW
Mailing Address - Street 1:555 TOWNER ST
Mailing Address - Street 2:P.O. BOX 915
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-5752
Mailing Address - Country:US
Mailing Address - Phone:734-544-3000
Mailing Address - Fax:
Practice Address - Street 1:2140 E ELLSWORTH RD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-2552
Practice Address - Country:US
Practice Address - Phone:734-222-3573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-12
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802086826104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker