Most Relevant Information
Provider Data
| NPI Number: | 1003554064 |
| Provider Name: | LISA DIANNE TAMS LMSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 6801067410 |
Most Important Dates
| Enumeration Date: | 05/20/2022 |
| Last Updated: | 05/20/2022 |
Provider Practice Location
50361 HANCOCK ST
CANTON
MI
481886664
Practice Location Phone/Fax
| Phone: | 7347162185 |
| Fax: |
Provider Mailing Location
50361 HANCOCK ST
CANTON
MI
481886664
Provider Mailing Phone/Fax
| Phone: | 7347162185 |
| Fax: |