Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 6801060473 | MI |
NPI | 1003096413 |
---|---|
Provider Name | Ms. Michelle Klein |
First Address | West Bloomfield, MI 48323-3150 |
Second Address | West Bloomfield, MI 48322-4409 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2007 |
Last Update Date | 14/11/2007 |