Doctor Name: | REBECCA LYNN MAFFETONE |
NPI Number: | 1992827190 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW ACSW |
License Number: | 6801074044 |
Business Practice Address: | 2 Crocker Blvd Suite 101 Mt Clemens, MI - 48043 |
Business Phone Number: | 5864682269 |
Business Fax Number: | 5864684505 |
Mailing Address: | 47810 Burton Dr, SHELBY TOWNSHIP |
State: | MI |
Postal Code: | 483173114 |
Phone Number: | 5867310698 |
Fax Number: | |
NPI Enumeration Date: | 04/06/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 6801074044 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |