Organization
LAUREN LIETAERT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN LIETAERT NP (OWNER/MANAGING MEMBER/PMHNP)
(586) 533-5672
Entity
Organization
Contact information
Practice address
16645 15 MILE RD, CLINTON TOWNSHIP, MI 48035-2206
(586) 213-5505
(586) 213-5504
Mailing address
16645 15 MILE RD, CLINTON TOWNSHIP, MI 48035-2206
(586) 213-5505
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/18/2024
Last updated
01/18/2024
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