Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 6301009412 | MI |
NPI | 1033271606 |
---|---|
Provider Name | Christine Brzezinski |
First Address | Clinton Township, MI 48036-2421 |
Second Address | Warren, MI 48093-8700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 08/07/2007 |