Amallie Defonseka is a Clinical in Pontiac, Michigan. Amallie Defonseka practices all healthcare services and medical treatments related to Clinical. The NPI Number for Amallie Defonseka is 1306983119. The last update date is 2007-07-08.
Amallie Defonseka's current location address is 114 Orchard Lake Rd, Pontiac, Michigan. You can contact this provider via phone number 2488587766 and fax number 2488587201. The mailing address for Amallie Defonseka is 114 Orchard Lake Rd, Pontiac, Michigan. To know further, please read the information below!
Provider Profile Detail
Provider Name | Amallie Defonseka |
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Address | 114 Orchard Lake Rd, Pontiac, Michigan |
Phone Number | 2488587766 |
Fax Number | 2488587201 |
Sole Proprietor | N |
Credentials | LLMSW |
NPI Number Detail
NPI Number | 1306983119 |
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Provider Enumeration Date | 2007-01-31 |
Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
Address | 114 Orchard Lake Rd |
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City | Pontiac |
State | Michigan (MI) |
Post Code | 483412244 |
Phone Number | 2488587766 |
Fax Number | 2488587201 |
Provider's Primary Taxonomy Detail
Speciality | Clinical |
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Taxonomy | 1041C0700X |
Licence No | 6801086171 |
Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
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1883825 | MI | -- |
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What is the unique identification code assigned to Amallie Defonseka by the Centers for Medicare & Medicaid Services?
The Amallie Defonseka has been issued the NPI (National Provider Identifier) 1306983119. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Amallie Defonseka?
The Amallie Defonseka is physically situated at 114 Orchard Lake Rd, in the city of Pontiac, state of MI, with the postal code 483412244.
What is Amallie Defonseka's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Amallie Defonseka is Clinical, and the corresponding taxonomy classification code for this specialized field is 1041C0700X.
On what date did the Centers for Medicare & Medicaid Services assign the 1306983119 to Amallie Defonseka?
The Centers for Medicare & Medicaid Services assigned the 1306983119 to Amallie Defonseka on 2007-01-31.
When was the information regarding Amallie Defonseka most recently updated?
The details pertaining to the Amallie Defonseka, including its address, specialty, and other relevant information, were last refreshed on 2007-07-08.