Provider Demographics
NPI:1356076046
Name:JANKOWSKI, NATALIE
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:JANKOWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42815 GARFIELD RD STE 201
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-1143
Mailing Address - Country:US
Mailing Address - Phone:586-333-5328
Mailing Address - Fax:586-948-9304
Practice Address - Street 1:42815 GARFIELD RD STE 201
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-1143
Practice Address - Country:US
Practice Address - Phone:586-333-5328
Practice Address - Fax:586-948-9304
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451024124101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional