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General NPI Number Information
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NPI Number | 1811594609
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Entity Type | Individual
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Provider Name | CRAIG GROMEK LLPC
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Gender | Male
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Dates
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Enumeration Date | 10/05/2020
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Last Update Date | 10/05/2020
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Provider Practice Location Address
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Address Line | 145 ROCHDALE DR S STE F
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City | ROCHESTER HILLS
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State | MI
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Zip | 48309-2275
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Country | US
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Telephone | 248-609-3127
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Fax |
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Provider Business Mailing Address
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Address Line | 320 N CROOKS RD APT 222
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City | CLAWSON
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State | MI
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Zip | 48017-1355
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Country | US
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Telephone | 517-285-4060
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Fax |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6401018517
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License Number State | MI
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