Healthcare Provider Details

I. General information

NPI: 1902712565
Provider Name (Legal Business Name): JESSICA HAAPALA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 E KEARSLEY ST
FLINT MI
48502-1907
US

IV. Provider business mailing address

41414 BROQUET DR
NORTHVILLE MI
48167-2462
US

V. Phone/Fax

Practice location:
  • Phone: 810-762-3147
  • Fax:
Mailing address:
  • Phone: 248-837-9328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: