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Individual
MARIA KLOECKNER
Active
Individual
MARIA KLOECKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLMSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801100688
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6801100688
LIMITED LICENSE MASTER SOCIAL WORKER
MI
Enumeration date
02/25/2018
Last updated
04/04/2019
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