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Individual

GENEVA ALLEN MCKELTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
15801 W MCNICHOLS RD, DETROIT, MI 48235-3543
(313) 272-8450
Mailing address
15801 W MCNICHOLS RD, DETROIT, MI 48235-3543
(313) 272-8450

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801072558
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5255236
MI
01
651245437
COMMERCIAL
MI
Enumeration date
05/27/2008
Last updated
05/28/2008
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