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NPI Code Detail

MEDICARE: MRS. ESTHER C. CLEGG M.A.

MEDICARE: MRS. ESTHER C. CLEGG M.A.
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
1101Y00000XCounselorL901731MI

General Provider Information

NPI Number : 1346371010
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ESTHER C. CLEGG M.A.
Provider Business Mailing Address
First Line : 1107 IRVING AVE
Second Line :
City : ROYAL OAK
State : MI
Zip : 48067-3312
Country : US
Telephone Number : 248-730-5540
Fax Number :
Provider Business Practice Location Address
First Line : 37634 ENTERPRISE CT
Second Line :
City : FARMINGTON HILLS
State : MI
Zip : 48331-3440
Country : US
Telephone Number : 248-553-0902
Fax Number : 248-553-2632
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2007
Last Update Date : 07/08/2007

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