Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 6401011374 | MI |
NPI | 1003046442 |
---|---|
Provider Name | Ms. Diane K Schalk |
First Address | Clinton Township, MI 48036-1684 |
Second Address | Clinton Township, MI 48036-1684 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2009 |
Last Update Date | 20/07/2009 |