Healthcare Provider Details

I. General information

NPI: 1548101025
Provider Name (Legal Business Name): DANIELLE SIENKIEWICZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HERITAGE DR STE 261
SOUTHGATE MI
48195-2574
US

IV. Provider business mailing address

1 HERITAGE DR STE 261
SOUTHGATE MI
48195-2574
US

V. Phone/Fax

Practice location:
  • Phone: 734-778-0663
  • Fax:
Mailing address:
  • Phone: 734-778-0663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: