Provider Demographics
NPI:1184721508
Name:WOLSCHON, PATRICIA ANN (MSW)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANN
Last Name:WOLSCHON
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 1:4646 JOHN R (11MH-DOM)
Mailing Address - Street 2:JOHN D. DINGELL VA MEDICAL CENTER
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201
Mailing Address - Country:US
Mailing Address - Phone:313-576-1553
Mailing Address - Fax:313-576-1570
Practice Address - Street 1:4646 JOHN R (11MH-DOM)
Practice Address - Street 2:JOHN D. DINGELL VA MEDICAL CENTER
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:313-576-1553
Practice Address - Fax:313-576-1570
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801020619104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker