Individual
MRS. MICHELLE ANN DATTADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
5878 FARINGDON PL, RALEIGH, NC 27609-4589
(919) 872-4833
Mailing address
5878 FARINGDON PL, RALEIGH, NC 27609-4589
(919) 872-4833
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
33SL05490100
NJ
104100000X
Social Worker
Primary
P004806
NC
Other
Enumeration date
02/24/2009
Last updated
11/18/2010
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