Mld Supervision & Therapy, LLC

NPI #1396553459 in Gaylord, Michigan

Provider Information

NPI Number: 1396553459
Entity Type: Organization
Organization Name: Mld Supervision & Therapy, LLC
Primary Specialty: Social Worker - Clinical
Enumeration Date: Dec 20, 2024
Last Updated: Dec 20, 2024

Practice Location

Address: 127 W STEWART ST
City: Gaylord
State: Michigan
ZIP Code: 49735-1539
Phone: (989) 217-8219

Authorized Official

Name: MARISSA LYNN LUCK-DAMER, LMSW
Title: OWNER/MENTAL HEALTH PROFESSIONAL
Phone: (989) 217-8219

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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