Individual
JACQUELYNN AMALFITANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LLMSW
Contact information
Practice address
12800 E WARREN AVE, DETROIT, MI 48215-2061
(248) 423-1728
Mailing address
24925 BECK AVE, EASTPOINTE, MI 48021-1463
(586) 872-4633
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
6801093009
MI
Other
Enumeration date
08/10/2011
Last updated
06/28/2013
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