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General NPI Number Information
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NPI Number | 1336267632
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Entity Type | Individual
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Provider Name | PATRICIA ANN DULKA LMSW ACSW
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Gender | Female
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 199 N BROAD ST
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City | ADRIAN
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State | MI
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Zip | 49221-2762
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Country | US
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Telephone | 517-263-2191
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Fax | 517-264-6080
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Provider Business Mailing Address
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Address Line | 707 E SIENA HEIGHTS DR APT 7
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City | ADRIAN
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State | MI
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Zip | 49221-1766
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Country | US
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Telephone | 517-266-2521
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 68010734334
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License Number State | MI
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