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General NPI Number Information
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NPI Number | 1225046394
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Entity Type | Individual
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Provider Name | MARINA VICINI POKRIEFKA CNS
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Gender | Female
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 12850 FOUNTAIN SQ STE. 106
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City | DAVISBURG
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State | MI
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Zip | 48350-2552
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Country | US
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Telephone | 248-634-6303
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Fax | 248-634-1746
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Provider Business Mailing Address
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Address Line | 12850 FOUNTAIN SQ STE. 106
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City | DAVISBURG
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State | MI
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Zip | 48350-2552
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Country | US
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Telephone | 248-634-6303
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Fax | 248-634-1746
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 4704115134
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 4704115134
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License Number State | MI
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