Healthcare Provider Details
I. General information
NPI: 1841096989
Provider Name (Legal Business Name): KAYTE S GRZENIA BSW, DP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/20/2025
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1009 WASHINGTON AVE
BAY CITY MI
48708-5705
US
IV. Provider business mailing address
8755 CARTER RD APT 19
FREELAND MI
48623-8767
US
V. Phone/Fax
- Phone: 989-928-3566
- Fax:
- Phone: 989-482-6956
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: