Individual
SAMANTHA WISNESKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3178 HILTON RD, FERNDALE, MI 48220-1059
(248) 629-4600
Mailing address
625 S MARIAS AVE, CLAWSON, MI 48017-1892
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401224677
MI
Other
Enumeration date
11/02/2021
Last updated
12/30/2024
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