Provider Demographics
NPI:1932634219
Name:PIETRUCK THERAPY SERVICES PLLC
Entity Type:Organization
Organization Name:PIETRUCK THERAPY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:PIETRUCK
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-786-2626
Mailing Address - Street 1:220 COLLINGWOOD ST STE 130
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-3842
Mailing Address - Country:US
Mailing Address - Phone:734-786-2626
Mailing Address - Fax:734-997-5015
Practice Address - Street 1:220 COLLINGWOOD ST STE 130
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-3842
Practice Address - Country:US
Practice Address - Phone:734-786-2626
Practice Address - Fax:734-997-5015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-25
Last Update Date:2024-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty