Individual
MS. CAITLIN THERESE QUENNEVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
18316 MIDDLEBELT, LIVONIA, MI 48152
(248) 615-9730
(248) 615-1260
Mailing address
18316 MIDDLEBELT, LIVONIA, MI 48152
(248) 615-9730
(248) 615-1260
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
6801094854
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
197749
—
OR
Enumeration date
06/04/2010
Last updated
08/05/2015
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