Kelly Michael Bassham, LMSW Valid NPI

Individual provider · Clinical Social Worker · Birmingham, MI

NPI

1023363488

Type

Individual (Type 1)

Primary specialty

Clinical Social Worker (Social Worker)

Specialty group

Behavioral Health & Social Service Providers

Taxonomy code

1041C0700X

License number

6801090908 (MI)

Sex

Male

Sole proprietor

Yes

Enumerated

2012-07-20

Last updated

2021-09-05