Healthcare Provider Details

I. General information

NPI: 1437097565
Provider Name (Legal Business Name): KYLA ANNE MARCIAL LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 OAKWOOD DR STE 114
ROCHESTER MI
48307-6206
US

IV. Provider business mailing address

2984 INVITATIONAL DR
OAKLAND MI
48363-2457
US

V. Phone/Fax

Practice location:
  • Phone: 248-220-3198
  • Fax:
Mailing address:
  • Phone: 586-596-9005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801081073
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: