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Organization
MICHELLE DATTADA, LCSW, PLLC
Active
Organization
MICHELLE DATTADA, LCSW, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE ANN DATTADA LCSW (OWNER)
(732) 485-3956
Entity
Organization
Contact information
Practice address
992 DURHAM RD STE A, WAKE FOREST, NC 27587-6590
(732) 485-3956
Mailing address
1404 LAGERFELD WAY, WAKE FOREST, NC 27587
(732) 485-3956
(919) 457-0174
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C007061
NC
Other
Enumeration date
05/15/2012
Last updated
05/15/2012
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