Individual
MACIEJ MICIAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC/MHSP
Contact information
Practice address
311 E MAIN ST STE 4, HENDERSONVILLE, TN 37075-2582
(615) 815-0895
Mailing address
121 WINDMILL POINTE CIR, HENDERSONVILLE, TN 37075-4885
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5815
TN
Other
Enumeration date
02/01/2022
Last updated
08/28/2024
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