Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 4704101106 | MI |
NPI | 1023227048 |
---|---|
Provider Name | Susan G Szczesny |
First Address | Hamtramck, MI 48212-2968 |
Second Address | Hamtramck, MI 48212-2968 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 08/07/2007 |