Healthcare Provider Details

I. General information

NPI: 1174446694
Provider Name (Legal Business Name): KRISTEN BIELECKI MPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6389 CLARKSTON RD
CLARKSTON MI
48346-1613
US

IV. Provider business mailing address

2539 YORKSHIRE LN
BLOOMFIELD HILLS MI
48302-1073
US

V. Phone/Fax

Practice location:
  • Phone: 248-623-5400
  • Fax:
Mailing address:
  • Phone: 248-275-8327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501011191
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: