Provider Demographics
NPI:1831454719
Name:MARCIEL, ANNETTE MARIE (MED, LPC)
Entity type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:MARIE
Last Name:MARCIEL
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:103 TOLAN ST
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:MI
Mailing Address - Zip Code:48160-1302
Mailing Address - Country:US
Mailing Address - Phone:703-303-3419
Mailing Address - Fax:734-344-7431
Practice Address - Street 1:218 N 4TH AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-1472
Practice Address - Country:US
Practice Address - Phone:703-303-3419
Practice Address - Fax:734-344-7431
Is Sole Proprietor?:No
Enumeration Date:2012-07-07
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC14299101YM0800X
MI6401015812101YM0800X
VA0701005447101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health