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General NPI Number Information
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NPI Number | 1881552040
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Entity Type | Individual
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Provider Name | LAZO DORDESKI MA, LLC
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Gender | Male
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Dates
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Enumeration Date | 01/14/2026
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 900 W UNIVERSITY DR STE A-2
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City | ROCHESTER
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State | MI
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Zip | 48307-1817
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Country | US
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Telephone | 248-266-0920
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Fax |
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Provider Business Mailing Address
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Address Line | 2522 PARKWAY CT
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48316-5568
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Country | US
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Telephone | 248-266-0920
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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 | 6451024837
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License Number State | MI
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