Provider Demographics
NPI:1578740809
Name:DAVIES, JUNE ANNETTE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:JUNE
Middle Name:ANNETTE
Last Name:DAVIES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:JUNE
Other - Middle Name:ANNETTE
Other - Last Name:DAVIES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:4097 PINESTEAD DR
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48390-1344
Mailing Address - Country:US
Mailing Address - Phone:248-790-2566
Mailing Address - Fax:248-363-1527
Practice Address - Street 1:4097 PINESTEAD DR
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48390-1344
Practice Address - Country:US
Practice Address - Phone:248-790-2566
Practice Address - Fax:248-363-1527
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010139851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical