Provider Demographics
NPI:1588818827
Name:PATLEWICZ, ANNE RENEE (BA)
Entity Type:Individual
Prefix:MISS
First Name:ANNE
Middle Name:RENEE
Last Name:PATLEWICZ
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44899 CENTRE CT
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-5510
Mailing Address - Country:US
Mailing Address - Phone:586-792-1654
Mailing Address - Fax:586-792-1656
Practice Address - Street 1:44899 CENTRE CT
Practice Address - Street 2:SUITE 102
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-5510
Practice Address - Country:US
Practice Address - Phone:586-792-1654
Practice Address - Fax:586-792-1656
Is Sole Proprietor?:No
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL1409831104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker