Organization
STARFISH CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHLEEN MARIE GUTOWSKI PSY.D LMSW CCS CAAC (CLINCIAL PSYCHOLGIST/CEO)
(810) 622-0630
Entity
Organization
Contact information
Practice address
38 S RIDGE ST # 306, PORT SANILAC, MI 48469-9789
(810) 622-0630
(810) 622-0631
Mailing address
38 S RIDGE ST # 306, PORT SANILAC, MI 48469-9789
(810) 622-0630
(810) 622-0631
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6801087602
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MI
Enumeration date
07/15/2010
Last updated
01/04/2011
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