Individual
KIMBERLY VASICEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
19401 NORTHLINE RD BLDG 5, SOUTHGATE, MI 48195
(734) 785-7700
Mailing address
19401 NORTHLINE RD BLDG 5, SOUTHGATE, MI 48195-2277
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
6803086749
MI
Other
Enumeration date
07/24/2015
Last updated
09/12/2019
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