Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | 6801101074 | MI |
Y | 1041C0700X | Clinical Social Worker | 6801101074 | MI |
NPI | 1003330820 |
---|---|
Provider Name | Chelsea Mcleskey |
First Address | Clarkston, MI 48346-5102 |
Second Address | Clarkston, MI 48346-5102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2017 |
Last Update Date | 01/06/2021 |