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NPI Code Detail

MEDICARE: MARK MOSKAL LPC

MEDICARE: MARK MOSKAL LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor6401009003MI

General Provider Information

NPI Number : 1497774244
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK MOSKAL LPC
Provider Business Mailing Address
First Line : 12851 GRAND RIVER RD
Second Line :
City : BRIGHTON
State : MI
Zip : 48116-8506
Country : US
Telephone Number : 810-227-1211
Fax Number : 810-220-5509
Provider Business Practice Location Address
First Line : 12851 GRAND RIVER RD
Second Line :
City : BRIGHTON
State : MI
Zip : 48116-8506
Country : US
Telephone Number : 810-227-1211
Fax Number : 810-220-5509
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2006
Last Update Date : 05/10/2017

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Directions to “ MARK MOSKAL LPC” Practice Location

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