Individual
TINA M CIEZKOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.C.M.H
Contact information
Practice address
3751 E PORTOLA VALLEY DR, GILBERT, AZ 85297-7876
(516) 376-1099
Mailing address
3751 E PORTOLA VALLEY DR, GILBERT, AZ 85297-7876
(516) 376-1099
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
—
AZ
103TP2701X
Group Psychotherapy Psychologist
Primary
—
AZ
Other
Enumeration date
11/04/2021
Last updated
11/04/2021
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