Individual
MRS. CARMEN SUE WISNIEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2805 PONTIAC LAKE RD, WATERFORD, MI 48328-2680
(248) 209-2406
(248) 209-2466
Mailing address
2805 PONTIAC LAKE RD, WATERFORD, MI 48328-2680
(248) 209-2406
(248) 209-2466
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802088921
MI
Other
Enumeration date
05/09/2016
Last updated
05/16/2016
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