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NPI Code Detail

MEDICARE: KATHERINE MARY OLEKSIAK LLMSW

MEDICARE:   KATHERINE MARY OLEKSIAK  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
11041C0700XClinical Social Worker6801091764MI

General Provider Information

NPI Number : 1508255969
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE MARY OLEKSIAK LLMSW
Provider Business Mailing Address
First Line : 25912 ANNAPOLIS ST
Second Line :
City : INKSTER
State : MI
Zip : 48141-3201
Country : US
Telephone Number : 313-565-2174
Fax Number :
Provider Business Practice Location Address
First Line : 25912 ANNAPOLIS ST
Second Line :
City : INKSTER
State : MI
Zip : 48141-3201
Country : US
Telephone Number : 313-565-2174
Fax Number : 313-565-2189
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2015
Last Update Date : 01/22/2015

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Directions to “ KATHERINE MARY OLEKSIAK LLMSW” Practice Location

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