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General NPI Number Information
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NPI Number | 1114773629
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Entity Type | Organization
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Legal Business Name | ALICIA WEISENSEL, MS PLLC
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Dates
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Enumeration Date | 04/25/2024
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Last Update Date | 04/25/2024
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Provider Practice Location Address
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Address Line | 27780 NOVI RD STE 107
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City | NOVI
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State | MI
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Zip | 48377-3401
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Country | US
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Telephone | 248-962-3325
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Fax |
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Provider Business Mailing Address
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Address Line | 4007 CARPENTER RD # 254
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City | YPSILANTI
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State | MI
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Zip | 48197-9644
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | ALICIA WEISENSEL
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Credential | MS, LLP
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Telephone | 248-962-3325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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