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Organization
MLD SUPERVISION & THERAPY, LLC
Active
Organization
MLD SUPERVISION & THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARISSA LYNN LUCK-DAMER LMSW (OWNER/MENTAL HEALTH PROFESSIONAL)
(989) 217-8219
Entity
Organization
Contact information
Practice address
127 W STEWART ST, GAYLORD, MI 49735-1539
(989) 217-8219
Mailing address
127 W STEWART ST, GAYLORD, MI 49735-1539
(989) 217-8219
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
12/20/2024
Last updated
12/20/2024
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