Provider Demographics
NPI:1184868382
Name:LOVE, RAQUEL JANEE (LBSW)
Entity type:Individual
Prefix:MS
First Name:RAQUEL
Middle Name:JANEE
Last Name:LOVE
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26040 WOODVILLA
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-2617
Mailing Address - Country:US
Mailing Address - Phone:248-497-6160
Mailing Address - Fax:
Practice Address - Street 1:1270 DORIS ROAD
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326
Practice Address - Country:US
Practice Address - Phone:586-201-4218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-01
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802080407104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker