Provider Demographics
NPI:1497974471
Name:JOSLIN, MARY A (MSW)
Entity Type:Individual
Prefix:MR
First Name:MARY
Middle Name:A
Last Name:JOSLIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3858 VISTA PARK
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-4420
Mailing Address - Country:US
Mailing Address - Phone:231-947-7270
Mailing Address - Fax:
Practice Address - Street 1:500 S UNION ST
Practice Address - Street 2:SUITE 4
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-3290
Practice Address - Country:US
Practice Address - Phone:231-947-7270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010197201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical