Doctor Name: | MRS. STACEY MARIE HILTZ KAMINSKI |
NPI Number: | 1043599574 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LLPC |
License Number: | 6401012071 |
Business Practice Address: | 305 S Canal St Lake City, MI - 496518859 |
Business Phone Number: | 2313428105 |
Business Fax Number: | |
Mailing Address: | 305 S Canal St, LAKE CITY |
State: | MI |
Postal Code: | 496518859 |
Phone Number: | 2313428105 |
Fax Number: | |
NPI Enumeration Date: | 08/15/2011 |
NPI Last Update Date: | 08/15/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 6401012071 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |