Healthcare Provider Details

I. General information

NPI: 1457667651
Provider Name (Legal Business Name): KAROLINA MARIA REDZINIAK MA, TLLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2010
Last Update Date: 08/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

441 S LIVERNOIS RD SUITE 205
ROCHESTER HILLS MI
48307-2584
US

IV. Provider business mailing address

441 S LIVERNOIS RD SUITE 205
ROCHESTER HILLS MI
48307-2584
US

V. Phone/Fax

Practice location:
  • Phone: 248-608-8800
  • Fax:
Mailing address:
  • Phone: 248-608-8800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number6301014553
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: