MEDICARE: SENSORY TECHNOLOGY SERVICES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center
2	261QH0700X	Hearing and Speech Clinic/Center

General Provider Information

NPI Number	:	1831602481
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SENSORY TECHNOLOGY SERVICES, INC

Provider Business Mailing Address
First Line	:	37395 CHARTER OAKS BLVD
Second Line	:
City	:	CLINTON TWP
State	:	MI
Zip	:	48036-2413
Country	:	US
Telephone Number	:	313-426-3443
Fax Number	:

Provider Business Practice Location Address
First Line	:	37395 CHARTER OAKS BLVD
Second Line	:
City	:	CLINTON TWP
State	:	MI
Zip	:	48036-2413
Country	:	US
Telephone Number	:	313-426-3443
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	STACIE WILSON
Credential	:
Telephone Number	:	313-888-3443

Provider Enumeration Date	:	11/06/2017
Last Update Date	:	11/10/2020

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