Individual
ALICA M WRZESINSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
56345 COUNTY ROAD 384, GRAND JUNCTION, MI 49056-9753
(269) 434-6959
Mailing address
56345 COUNTY ROAD 384, GRAND JUNCTION, MI 49056-9753
(269) 434-6959
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
AF800238276
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AF800238276
—
MI
Enumeration date
02/19/2018
Last updated
02/19/2018
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