MEDICARE: KAYLIE ENGLER LLMSW

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	6851116494	MI

General Provider Information

NPI Number	:	1063237543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLIE ENGLER LLMSW

Provider Business Mailing Address
First Line	:	5087 US HIGHWAY 41 S
Second Line	:
City	:	MARQUETTE
State	:	MI
Zip	:	49855-9001
Country	:	US
Telephone Number	:	906-263-0080
Fax Number	:

Provider Business Practice Location Address
First Line	:	5087 US HIGHWAY 41 S
Second Line	:
City	:	MARQUETTE
State	:	MI
Zip	:	49855-9001
Country	:	US
Telephone Number	:	906-263-0080
Fax Number	:

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

Provider Enumeration Date	:	11/19/2024
Last Update Date	:	11/19/2024

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