Individual
MARISA QUINN MIECZKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 RENAISSANCE CTR STE 2600, DETROIT, MI 48243-1502
(855) 832-6727
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
MI
106S00000X
Behavior Technician
—
—
156F00000X
Technician/Technologist
—
—
Other
Enumeration date
08/14/2018
Last updated
03/01/2021
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