Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 7501000900 | MI |
NPI | 1013467034 |
---|---|
Provider Name | Melissa Swieczkowski |
First Address | Farmington Hills, MI 48335-3123 |
Second Address | Farmington Hills, MI 48335-3123 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2016 |
Last Update Date | 13/10/2016 |