Michael Jeffery Kieke, LICSW
Social Worker, Clinical in Hutchinson, MN. Individual provider (NPI-1).
NPI number1982162228
StatusActive
Last updated in NPPESNov 12, 2024
Details
- NPI
- 1982162228
- Entity type
- Individual (NPI-1)
- Name
- Mr. Michael Jeffery Kieke
- Credential
- LICSW
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 6, 2019
- Certification date
- Nov 12, 2024
- Last updated
- Nov 12, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 19015 | MN | Yes |
Practice location
155 Shady Ridge Rd NwHutchinson, MN 55350-1460
Phone 320-234-3451
Mailing address
155 Shady Ridge Rd NwHutchinson, MN 55350-1460
Phone 320-234-3451 · Fax 320-587-0993
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