IndividualActive
Amallie Defonseka, LLMSW
NPI 1306983119 · Clinical Social Worker · Pontiac, MI
Provider details
- NPI number
- 1306983119
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LLMSW
- Sex
- Female
- Sole proprietor
- No
- License
- 6801086171 (MI)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
114 Orchard Lake Rd
Pontiac, MI 48341-2244
Phone: (248) 858-7766
Fax: (248) 858-7201
Approximate (ZIP-level) locationGet directions
Mailing address
114 Orchard Lake Rd
Pontiac, MI 48341-2244
Registry dates
- Enumerated
- 2007-01-31
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.