MEDICARE: DEANNA FLETCHER LMSW LLC

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

General Provider Information

NPI Number	:	1023528874
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEANNA FLETCHER LMSW LLC

Provider Business Mailing Address
First Line	:	1122 N LEROY ST STE A
Second Line	:
City	:	FENTON
State	:	MI
Zip	:	48430-2789
Country	:	US
Telephone Number	:	810-215-1414
Fax Number	:

Provider Business Practice Location Address
First Line	:	1122 N LEROY ST STE A
Second Line	:
City	:	FENTON
State	:	MI
Zip	:	48430-2789
Country	:	US
Telephone Number	:	810-215-1414
Fax Number	:

Authorized Official
Title or Position	:	LMSW
Name	:	DEANNA FLETCHER
Credential	:
Telephone Number	:	810-215-1414

Provider Enumeration Date	:	10/06/2017
Last Update Date	:	02/25/2019

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