Healthcare Provider Details

I. General information

NPI: 1558976365
Provider Name (Legal Business Name): HANNAH FAYE FINN PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2020
Last Update Date: 12/01/2021
Certification Date: 12/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 GENOA BUSINESS PARK DR STE 270
BRIGHTON MI
48114-7369
US

IV. Provider business mailing address

6404 RICHALLE ST
BRIGHTON MI
48116-2157
US

V. Phone/Fax

Practice location:
  • Phone: 810-772-4964
  • Fax:
Mailing address:
  • Phone: 989-817-8288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: