Jodie Rebecca Heicklen, LMSW
Social Worker in Southfield, MI. Individual provider (NPI-1).
NPI number1982194668
StatusActive
Last updated in NPPESMay 17, 2018
Details
- NPI
- 1982194668
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Jodie Rebecca Heicklen
- Credential
- LMSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 17, 2018
- Last updated
- May 17, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 104100000X | Social Worker | 6801093976 | MI | Yes |
Practice location
17344 W 12 Mile Rd Ste 207Southfield, MI 48076-6321
Phone 917-536-2330
Mailing address
25507 Hereford DrHuntington Woods, MI 48070-1639
Phone 917-536-2330
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