Mary Kathryn Bicknell
Social Worker, Clinical in Detroit, MI. Individual provider (NPI-1).
NPI number1295366995
StatusActive
Last updated in NPPESJan 31, 2020
Details
- NPI
- 1295366995
- Entity type
- Individual (NPI-1)
- Name
- Mary Kathryn Bicknell
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 31, 2020
- Certification date
- Jan 31, 2020
- Last updated
- Jan 31, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 6801100260 | MI | Yes |
Practice location
17421 Telegraph RdDetroit, MI 48219-3165
Phone 313-531-2500
Mailing address
43715 Simsbury StCanton, MI 48187-2710
Phone 770-815-2303
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