Provider Demographics
NPI:1326869256
Name:KWIATKOWSKI, MARIA MILES (LMSW)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:MILES
Last Name:KWIATKOWSKI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 KARA CT
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-1537
Mailing Address - Country:US
Mailing Address - Phone:616-498-4290
Mailing Address - Fax:
Practice Address - Street 1:124 KARA CT
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:MI
Practice Address - Zip Code:49341-1537
Practice Address - Country:US
Practice Address - Phone:616-498-4290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010737741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical