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Individual

AMANDA MARIE PONCIL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
17515 W 9 MILE RD STE 345, SOUTHFIELD, MI 48075-4403
(734) 497-8986
Mailing address
1 FORD PL STE 3A, DETROIT, MI 48202-3450

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801099161
MI
1041C0700X
Clinical Social Worker

Other

Enumeration date
03/03/2016
Last updated
04/03/2023
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