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NPI Code Detail

MEDICARE: MRS. MICHELLE LYNN HOLLENKAMP M.S.W.

MEDICARE:  MRS. MICHELLE LYNN HOLLENKAMP  M.S.W.
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
11041C0700XClinical Social Worker1971KY

General Provider Information

NPI Number : 1831108075
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MICHELLE LYNN HOLLENKAMP M.S.W.
Provider Business Mailing Address
First Line : 1455 S FORT THOMAS AVE
Second Line :
City : FORT THOMAS
State : KY
Zip : 41075-2453
Country : US
Telephone Number : 859-442-8439
Fax Number :
Provider Business Practice Location Address
First Line : 1455 S FORT THOMAS AVE
Second Line :
City : FORT THOMAS
State : KY
Zip : 41075-2453
Country : US
Telephone Number : 859-442-8439
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. MICHELLE LYNN HOLLENKAMP M.S.W.” Practice Location

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