Healthcare Provider Details

I. General information

NPI: 1548020928
Provider Name (Legal Business Name): SARA GURUJI PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2024
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 HOGBACK RD
ANN ARBOR MI
48105-9752
US

IV. Provider business mailing address

2020 HOGBACK RD
ANN ARBOR MI
48105-9752
US

V. Phone/Fax

Practice location:
  • Phone: 248-832-1339
  • Fax:
Mailing address:
  • Phone: 248-832-1339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AKANKSHA MADAN
Title or Position: LPC
Credential: LPC
Phone: 248-832-1339