Healthcare Provider Details

I. General information

NPI: 1831002716
Provider Name (Legal Business Name): PATRICIA ADER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 BEAUBIEN ST
DETROIT MI
48201-2166
US

IV. Provider business mailing address

22900 CANTERBURY ST
SAINT CLAIR SHORES MI
48080-1921
US

V. Phone/Fax

Practice location:
  • Phone: 313-832-8931
  • Fax:
Mailing address:
  • Phone: 313-832-8931
  • Fax: 313-966-7443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501019932
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: