Individual
LAUREN WISNESKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15600 19 MILE RD, CLINTON TOWNSHIP, MI 48038-3502
(586) 917-6616
Mailing address
12815 CLOVERLAWN DR, STERLING HEIGHTS, MI 48312-1611
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/25/2021
Last updated
08/25/2021
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