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Individual

MANDI MARIE CIACELLI-BROWN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
3250 N MONROE ST, MONROE, MI 48162-9297
(734) 384-3402
Mailing address
467 GODFROY AVE, MONROE, MI 48162-2766
(734) 344-2504

Taxonomy

Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
4703095538
MI
324500000X
Substance Abuse Rehabilitation Facility
Primary
4703095538
MI
364SR0400X
Rehabilitation Clinical Nurse Specialist
4703095538
MI

Other

Enumeration date
05/08/2019
Last updated
05/08/2019
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