Healthcare Provider Details

I. General information

NPI: 1811833098
Provider Name (Legal Business Name): GRACE LAUREN SOVA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2215 FULLER RD # 11G
ANN ARBOR MI
48105-2303
US

IV. Provider business mailing address

2215 FULLER RD # 11G
ANN ARBOR MI
48105-2303
US

V. Phone/Fax

Practice location:
  • Phone: 734-845-3877
  • Fax:
Mailing address:
  • Phone: 734-845-3877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: