Basic Information
| Provider Information | |||||||||
| NPI: | 1023334380 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KLINSKI | ||||||||
| FirstName: | WENDALA | ||||||||
| MiddleName: | K. | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LPC, CAADC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 177 W WILLIS RD | ||||||||
| Address2: | |||||||||
| City: | SALINE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481769427 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7342403850 | ||||||||
| FaxNumber: | 7342403863 | ||||||||
| Practice Location | |||||||||
| Address1: | 1070 S TELEGRAPH RD | ||||||||
| Address2: | |||||||||
| City: | MONROE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481614056 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7342403850 | ||||||||
| FaxNumber: | 7342403863 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2010 | ||||||||
| LastUpdateDate: | 12/01/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 6401011707 | MI | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.