Doctor Name: | MICHELLE L HAVIKEN |
NPI Number: | 1205081106 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 073711-1 |
Business Practice Address: | 1234w Broadway Hewlett, NY - 115571929 |
Business Phone Number: | 9173591388 |
Business Fax Number: | |
Mailing Address: | 1234w Broadway, HEWLETT |
State: | NY |
Postal Code: | 115571929 |
Phone Number: | 9173591388 |
Fax Number: | |
NPI Enumeration Date: | 11/20/2008 |
NPI Last Update Date: | 07/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 073711-1 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |