Healthcare Provider Details
I. General information
NPI: 1205936812
Provider Name (Legal Business Name): KATHRYN ANN SARGENT MS, CGC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
826 WASHINGTON RD
GROSSE POINTE MI
48230-1291
US
IV. Provider business mailing address
826 WASHINGTON RD
GROSSE POINTE MI
48230-1291
US
V. Phone/Fax
- Phone: 313-885-5605
- Fax:
- Phone: 313-885-5605
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 170300000X |
| Taxonomy | Genetic Counselor (M.S.) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: