Healthcare Provider Details
I. General information
NPI: 1386481174
Provider Name (Legal Business Name): MISS JESSICA SATEI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/10/2024
Last Update Date: 08/12/2024
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3901 BEAUBIEN BLVD
DETROIT MI
48201
US
IV. Provider business mailing address
9 SHADY OAKS CRESCENT
TORONTO ONTARIO
M3C 2L4
CA
V. Phone/Fax
- Phone: 313-745-5437
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: