Provider Demographics
NPI:1003647033
Name:KACMAREK, NELL
Entity type:Individual
Prefix:
First Name:NELL
Middle Name:
Last Name:KACMAREK
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 1:405 CAMBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DEXTER
Mailing Address - State:MI
Mailing Address - Zip Code:48130-2508
Mailing Address - Country:US
Mailing Address - Phone:734-845-2966
Mailing Address - Fax:
Practice Address - Street 1:7007 DEXTER ANN ARBOR RD STE A
Practice Address - Street 2:
Practice Address - City:DEXTER
Practice Address - State:MI
Practice Address - Zip Code:48130-8568
Practice Address - Country:US
Practice Address - Phone:734-680-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist