Healthcare Provider Details

I. General information

NPI: 1104695667
Provider Name (Legal Business Name): CENTER FOR INTEGRATIVE NEUROSCIENCE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2023
Last Update Date: 02/12/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 W SEVENTH ST UNIT A
TRAVERSE CITY MI
49684-2438
US

IV. Provider business mailing address

819 W SEVENTH ST UNIT A
TRAVERSE CITY MI
49684-2438
US

V. Phone/Fax

Practice location:
  • Phone: 231-622-1928
  • Fax:
Mailing address:
  • Phone: 231-622-1928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ELIZABETH MARIE TEKLINSKI
Title or Position: OWNER
Credential: PHD, LPC
Phone: 231-622-1928