Provider Information for 1295004448
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Mr. MICHAEL L JANKOWSKI LMSW
Sex: Male
NPI: 1295004448
Last Updated: 2021-09-28
Certification Date: 2021-09-28
Certification Date: 2021-09-28
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1295004448 | ||||||||
| Enumeration Date | 2011-12-16 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 949 WEALTHY ST SE STE 205 GRAND RAPIDS, MI 49506-1596 United States Phone: 616-446-7265 | Fax: | ||||||||
| Primary Practice Address | 949 WEALTHY ST SE STE 205 GRAND RAPIDS, MI 49506-1596 United States Phone: 616-446-7265 | Fax: | ||||||||
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