Provider Demographics
NPI:1063711679
Name:ZEITLIN, LAURA (MSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:ZEITLIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 E. MEDICAL CENTER DR
Mailing Address - Street 2:D2202 MEDICAL PROFESSIONAL BLD
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-5718
Mailing Address - Country:US
Mailing Address - Phone:734-936-7090
Mailing Address - Fax:734-763-9950
Practice Address - Street 1:1500 E. MEDICAL CENTER DR
Practice Address - Street 2:D2202 MEDICAL PROFESSIONAL BLD
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5718
Practice Address - Country:US
Practice Address - Phone:734-936-7090
Practice Address - Fax:734-763-9950
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-22
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010725121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical