Healthcare Provider Details

I. General information

NPI: 1760996466
Provider Name (Legal Business Name): AMY VIRGINIA KUZNIAR LPC, ATR-BC, SCL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2017
Last Update Date: 01/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 WOODSIDE PARK BLVD
PLEASANT RIDGE MI
48069-1041
US

IV. Provider business mailing address

8 WOODSIDE PARK BLVD
PLEASANT RIDGE MI
48069-1041
US

V. Phone/Fax

Practice location:
  • Phone: 248-928-6496
  • Fax:
Mailing address:
  • Phone: 248-928-6496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246ZA2600X
TaxonomyMedical Art Specialist/Technologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401014025
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: