Provider Information for 1982433280
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Mr. KIRK TASKILA LMSW
Sex: Male
NPI: 1982433280
Last Updated: 2024-07-26
Certification Date: 2024-07-26
Certification Date: 2024-07-26
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1982433280 | ||||||||||||
| Enumeration Date | 2024-07-26 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1315 ILLINOIS AVE LANSING, MI 48906-4961 United States Phone: 517-281-4720 | Fax: | ||||||||||||
| Primary Practice Address | 1315 ILLINOIS AVE LANSING, MI 48906-4961 United States Phone: 517-281-4720 | Fax: | ||||||||||||
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