| Doctor Name: | MRS. MARINA VICINI POKRIEFKA |
| NPI Number: | 1225046394 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNS |
| License Number: | 4704115134 |
| Business Practice Address: | 12850 Fountain Sq Ste. 106 Davisburg, MI - 483502552 |
| Business Phone Number: | 2486346303 |
| Business Fax Number: | 2486341746 |
| Mailing Address: | 12850 Fountain Sq, Ste. 106 DAVISBURG |
| State: | MI |
| Postal Code: | 483502552 |
| Phone Number: | 2486346303 |
| Fax Number: | 2486341746 |
| NPI Enumeration Date: | 08/04/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SP0807X |
| License Number: | 4704115134 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Psych/Mental Health, Child & Adolescent |
| Taxonomy Definition: | |