Individual
BRANDI R WASILEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16647 WYOMING ST, DETROIT, MI 48221-2848
(313) 342-3606
(313) 861-0413
Mailing address
16647 WYOMING ST, DETROIT, MI 48221-2848
(313) 342-3606
(313) 861-0413
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
382471616
—
MI
Enumeration date
03/08/2019
Last updated
03/08/2019
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