| Katelyn M Maddock | |
|
48130 Royal Pointe Dr Canton MI 48187-5466 | |
| (734) 664-3345 | |
| (517) 323-9531 |
| Full Name | Katelyn M Maddock |
|---|---|
| Speciality | Social Worker |
| Location | 48130 Royal Pointe Dr, Canton, Michigan |
| Authorized Official Name and Position | Cathy Gallegos (CREDENTIALING MANAGER) |
| Authorized Official Contact | 5174832461 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Katelyn M Maddock 48130 Royal Pointe Dr Canton MI 48187-5466 Ph: (734) 207-5065 | Katelyn M Maddock 48130 Royal Pointe Dr Canton MI 48187-5466 Ph: (734) 664-3345 |
| NPI Number | 1174136550 |
|---|---|
| Provider Enumeration Date | 08/26/2020 |
| Last Update Date | 02/17/2022 |
| Certification Date | 02/17/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174136550 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
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