Provider Demographics
NPI:1629178165
Name:WINKENS, MARILYN CHRISTINE (MSW)
Entity Type:Individual
Prefix:PROF
First Name:MARILYN
Middle Name:CHRISTINE
Last Name:WINKENS
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 1:427 BLUEWATER DR
Mailing Address - Street 2:
Mailing Address - City:HOLLY
Mailing Address - State:MI
Mailing Address - Zip Code:48442-8631
Mailing Address - Country:US
Mailing Address - Phone:248-634-1692
Mailing Address - Fax:
Practice Address - Street 1:4950 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-1142
Practice Address - Country:US
Practice Address - Phone:248-420-4634
Practice Address - Fax:248-674-0083
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010003131041C0700X
MI4101005853106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist