Whalio Doctors

NPI 1003155219

Travis John Vanderlist, LMSW

Practitioner Clinical Social Worker Saginaw, MI

Practice location

Address
1500 Weiss St, Saginaw, MI 48602-5251
Phone
(989) 497-2500
Fax
(989) 321-4922
Mailing address
311 Oxford Rd, East Lansing, MI 48823-2628

Registered specialties

Clinical Social Worker Primary
Behavioral Health & Social Service Providers Taxonomy 1041C0700X Licence 6801090423 (MI)

Registry record

NPI
1003155219
Entity type
Individual
Sex (as registered)
Male
NPI issued
7 Feb 2013
Record last updated
7 Feb 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.