Individual
MS. CLARA RENEE MICKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
S.W.
Contact information
Practice address
2051 W GRAND BLVD, DETROIT, MI 48208-1105
(313) 961-3700
(313) 961-3769
Mailing address
2051 W GRAND BLVD, DETROIT, MI 48208-1105
(313) 961-3700
(313) 961-3769
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801064089
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6801064089
STATE LICENSE
MI
Enumeration date
08/31/2006
Last updated
07/08/2007
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