Organization
BLUESPACE COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI L BUCCIERE LMSW (OWNER)
(248) 880-8684
Entity
Organization
Contact information
Practice address
149 N CENTER ST, SUITE 200, NORTHVILLE, MI 48167-1486
(248) 880-8684
(734) 738-6980
Mailing address
44511 BROADMOOR BLVD, NORTHVILLE, MI 48168-8633
(248) 880-8684
(734) 738-6980
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801018346
MI
Other
Enumeration date
12/10/2014
Last updated
12/10/2014
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