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Individual

JOHN WILLIAM POLISKEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LLMFT

Contact information

Practice address
1777 AXTELL DR STE 100, TROY, MI 48084-4400
(248) 613-5377
Mailing address
201 WAGER ST, MANCHESTER, MI 48158-9684
(248) 212-8295

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
4101006819
MI

Other

Enumeration date
02/17/2019
Last updated
02/17/2019
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