Individual
MR. MICHAEL LAWRENCE HUBBARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223
(270) 798-8601
(270) 798-8239
Mailing address
10888 BELL STATION RD, OAK GROVE, KY 42262-9372
(270) 439-1934
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
942
GA
Other
Enumeration date
02/23/2006
Last updated
06/20/2018
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