Madison Marie Vandyke, LLMSW
Social Worker, Clinical in Redford, MI. Individual provider (NPI-1).
NPI number1164099115
StatusActive
Last updated in NPPESJun 8, 2021
Details
- NPI
- 1164099115
- Entity type
- Individual (NPI-1)
- Name
- Madison Marie Vandyke
- Credential
- LLMSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 8, 2021
- Certification date
- Jun 8, 2021
- Last updated
- Jun 8, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 6801109889 | MI | Yes |
Practice location
9315 Telegraph RdRedford, MI 48239-1260
Phone 313-450-4500
Mailing address
20882 Orchard Lake RdFarmington Hills, MI 48336-5223
Phone 248-819-6374
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