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Individual

JORDAN M. BRACISZEWSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2689
(313) 916-2600
Mailing address
50 HEALTH LN, WARWICK, RI 02886-2711
(401) 732-5656
(401) 738-8634

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301016725
MI

Other

Enumeration date
03/08/2011
Last updated
03/28/2018
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