=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811024359
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DR. ALEKSANDRA WILANOWSKI AND ASSOCIATES P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/28/2007
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 17177 N LAUREL PARK DR SUITE 437
-----------------------------------------------------
City | LIVONIA
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48152-2693
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-432-6066
-----------------------------------------------------
Fax | 734-432-6077
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 17177 N LAUREL PARK DR SUITE 437
-----------------------------------------------------
City | LIVONIA
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48152-2693
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-432-6066
-----------------------------------------------------
Fax | 734-432-6077
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PSYCHIATRIST , PRESIDENT
-----------------------------------------------------
Name | DR. ALEKSANDRA WILANOWSKI
-----------------------------------------------------
Credential | M.D.,
-----------------------------------------------------
Telephone | 734-432-6066
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0804X
-----------------------------------------------------
Taxonomy Name | Child & Adolescent Psychiatry Physician
-----------------------------------------------------
License Number | 4301066024
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number | 6301013326
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------