MEDICARE: MR. MICHAEL JOSEPH DROUILHET LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCS 8991	CA

General Provider Information

NPI Number	:	1659301307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL JOSEPH DROUILHET LCSW

Provider Business Mailing Address
First Line	:	2945 HARDING ST
Second Line	:	112
City	:	CARLSBAD
State	:	CA
Zip	:	92008-1818
Country	:	US
Telephone Number	:	760-720-0662
Fax Number	:	760-931-0728

Provider Business Practice Location Address
First Line	:	2945 HARDING ST
Second Line	:	STE 112
City	:	CARLSBAD
State	:	CA
Zip	:	92008-1818
Country	:	US
Telephone Number	:	760-720-0662
Fax Number	:	760-931-0728

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	07/08/2007

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