Provider Demographics
NPI:1942500830
Name:LECLEAR-DOZIER, MICHELLE S (MSW)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:S
Last Name:LECLEAR-DOZIER
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 1:34316 BLACK BASS CIR
Mailing Address - Street 2:
Mailing Address - City:FRUITLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:34731-6304
Mailing Address - Country:US
Mailing Address - Phone:734-945-2924
Mailing Address - Fax:
Practice Address - Street 1:34316 BLACK BASS CIR
Practice Address - Street 2:
Practice Address - City:FRUITLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:34731-6304
Practice Address - Country:US
Practice Address - Phone:734-945-2924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-26
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL140391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical