Provider Demographics
NPI:1407228380
Name:MCLEOD, MARYANNE WOJDA (MSW, LMSW, ACSW)
Entity type:Individual
Prefix:MS
First Name:MARYANNE
Middle Name:WOJDA
Last Name:MCLEOD
Suffix:
Gender:F
Credentials:MSW, LMSW, ACSW
Other - Prefix:
Other - First Name:MARYANNE
Other - Middle Name:
Other - Last Name:WOJDA-MCLEOD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW,LMSW, ACSW
Mailing Address - Street 1:1202 MINNESOTA AVE
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:MI
Mailing Address - Zip Code:49837-1404
Mailing Address - Country:US
Mailing Address - Phone:906-280-8496
Mailing Address - Fax:
Practice Address - Street 1:1010 DELTA AVE
Practice Address - Street 2:210
Practice Address - City:GLADSTONE
Practice Address - State:MI
Practice Address - Zip Code:49837-1553
Practice Address - Country:US
Practice Address - Phone:906-280-8496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010463591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical