Doctor Name: | MRS. MELISSA ANN CHACHULSKI |
NPI Number: | 1992987002 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LLMSW |
License Number: | 6801089249 |
Business Practice Address: | 515 S Parker St Ste D Marine City, MI - 480393553 |
Business Phone Number: | 8107655010 |
Business Fax Number: | |
Mailing Address: | 446 N Elizabeth St, MARINE CITY |
State: | MI |
Postal Code: | 480393408 |
Phone Number: | 5862952774 |
Fax Number: | |
NPI Enumeration Date: | 11/30/2007 |
NPI Last Update Date: | 11/30/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 6801089249 |
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 |