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NPI Code Detail

MEDICARE: ASHLEY MAE LEGAULT LLMSW

MEDICARE: ASHLEY MAE LEGAULT 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
1104100000XSocial Worker6801102360MI

General Provider Information

NPI Number : 1306335062
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY MAE LEGAULT LLMSW
Provider Business Mailing Address
First Line : 17177 N LAUREL PARK DR STE 131
Second Line :
City : LIVONIA
State : MI
Zip : 48152-3952
Country : US
Telephone Number : 734-462-3210
Fax Number : 734-462-1024
Provider Business Practice Location Address
First Line : 17177 N LAUREL PARK DR STE 131
Second Line :
City : LIVONIA
State : MI
Zip : 48152-3952
Country : US
Telephone Number : 734-462-3210
Fax Number : 734-462-1024
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2018
Last Update Date : 03/06/2026

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Directions to “ ASHLEY MAE LEGAULT LLMSW” Practice Location

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