Most Relevant Information
Provider Data
| NPI Number: | 1003670324 |
| Provider Name: | MIKENZI JEFFREY LLBSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 6852094138 |
Most Important Dates
| Enumeration Date: | 02/07/2024 |
| Last Updated: | 10/17/2024 |
Provider Practice Location
1332 PROSPECT AVE
CARO
MI
487239288
Practice Location Phone/Fax
| Phone: | 9896723174 |
| Fax: |
Provider Mailing Location
323 N STATE ST
CARO
MI
487231537
Provider Mailing Phone/Fax
| Phone: | 9896736191 |
| Fax: |