Individual
ANNA K DETLEFSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
50740 PRINCESS WAY STE 500, GRANGER, IN 46530-4339
(574) 607-7051
Mailing address
50740 PRINCESS WAY STE 500, GRANGER, IN 46530-4339
(574) 607-7051
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34008564A
IN
Other
Enumeration date
07/31/2019
Last updated
07/31/2019
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