Individual
CANDACE JEAN CACKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3200 W LIBERTY RD STE F, ANN ARBOR, MI 48103-9180
(734) 369-6002
Mailing address
3200 W LIBERTY RD STE F, ANN ARBOR, MI 48103-9180
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7151013311
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7151013311
STATE OF MICHIGAN - DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS
MI
Enumeration date
08/28/2020
Last updated
08/28/2020
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