Healthcare Provider Details

I. General information

NPI: 1467663260
Provider Name (Legal Business Name): MARIA CAUSIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23133 ORCHARD LAKE RD SUITE 206
FARMINGTON MI
48336-3268
US

IV. Provider business mailing address

31775 MARBLEHEAD ST
FARMINGTON MI
48336-2542
US

V. Phone/Fax

Practice location:
  • Phone: 248-888-6800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501011502
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: