Individual
MR. KENNETH ANTKOWIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS,LLP
Contact information
Practice address
2140 E ELLSWORTH RD, ANN ARBOR, MI 48108-2552
(734) 222-3500
(734) 971-2487
Mailing address
555 TOWNER ST, PO BOX 915, YPSILANTI, MI 48198-5752
(734) 544-3000
(734) 544-6732
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301003975
MI
Other
Enumeration date
02/27/2007
Last updated
07/08/2007
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