Most Relevant Information
Provider Data
| NPI Number: | 1003644758 |
| Provider Name: | HANNA MAE KOIVISTO |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/24/2024 |
| Last Updated: | 07/24/2024 |
Provider Practice Location
103 W US HIGHWAY 2
WAKEFIELD
MI
499689515
Practice Location Phone/Fax
| Phone: | 9062296120 |
| Fax: | 9062296191 |
Provider Mailing Location
103 W US HIGHWAY 2
WAKEFIELD
MI
499689515
Provider Mailing Phone/Fax
| Phone: | 9062296120 |
| Fax: | 9062296191 |