Provider Demographics
NPI:1023444148
Name:WALKER, MICHELE ANNETTE (BSW)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:ANNETTE
Last Name:WALKER
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6255 N SEYMOUR RD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433-1034
Mailing Address - Country:US
Mailing Address - Phone:810-867-4429
Mailing Address - Fax:
Practice Address - Street 1:3600 S DORT HWY
Practice Address - Street 2:SUITE 54
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-2093
Practice Address - Country:US
Practice Address - Phone:810-742-1800
Practice Address - Fax:810-742-2400
Is Sole Proprietor?:No
Enumeration Date:2013-09-20
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68020684951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical