Provider Information for 1659671766
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Ms. MICHELLE L. LOUISVILLE LCSW
Sex: Female
NPI: 1659671766
Last Updated: 2010-11-04
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1659671766 | ||||||||
| Enumeration Date | 2010-10-25 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1061 HARMON AVE SUITE 1D03 FORT STEWART, GA 31314-5641 United States Phone: 912-435-5265 | Fax: | ||||||||
| Primary Practice Address | 1061 HARMON AVE SUITE 1D03 FORT STEWART, GA 31314-5641 United States Phone: 912-435-5265 | Fax: | ||||||||
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