Healthcare Provider Details

I. General information

NPI: 1023676228
Provider Name (Legal Business Name): JARIN JAIGIRDAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2019
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 GRAND RIVER AVE
DETROIT MI
48204-2132
US

IV. Provider business mailing address

5915 ORCHARD WOODS DR
WEST BLOOMFIELD MI
48324-3278
US

V. Phone/Fax

Practice location:
  • Phone: 313-491-7920
  • Fax:
Mailing address:
  • Phone: 586-438-7997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number5201010419
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: