Healthcare Provider Details

I. General information

NPI: 1285506675
Provider Name (Legal Business Name): MARIA FELT CPHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2025
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5449 JACKSON RD
ANN ARBOR MI
48103-1861
US

IV. Provider business mailing address

5751 S AYLESBURY DR
WATERFORD MI
48327-2603
US

V. Phone/Fax

Practice location:
  • Phone: 734-332-3872
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number5303005412
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: