Doctor Name: | MOLLY JOSSLYN MICHAU |
NPI Number: | 1619128014 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW |
License Number: | 34003597A |
Business Practice Address: | 300 Prison Rd Represa, CA - 956713001 |
Business Phone Number: | 9169852561 |
Business Fax Number: | |
Mailing Address: | 1100 Roseville Pkwy, Apt. 314 ROSEVILLE |
State: | CA |
Postal Code: | 956784100 |
Phone Number: | 9167709375 |
Fax Number: | |
NPI Enumeration Date: | 10/02/2008 |
NPI Last Update Date: | 10/02/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 34003597A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |