Individual
MS. JANICE MARIE KORNACKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LLP
Contact information
Practice address
33101 ANNAPOLIS ST, WAYNE, MI 48184-2405
(734) 721-0200
Mailing address
24601 CHICAGO ST, DEARBORN, MI 48124-3106
(313) 792-9284
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301010055
MI
Other
Enumeration date
11/05/2006
Last updated
07/08/2007
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