Healthcare Provider Details

I. General information

NPI: 1255518056
Provider Name (Legal Business Name): MARI KAY SAVATSKY CERTIFIED THERAPEUTI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2008
Last Update Date: 01/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10400 HAMBURG RD
HAMBURG MI
48139
US

IV. Provider business mailing address

PO BOX 205 10400 HAMBURG RD
HAMBURG MI
48139
US

V. Phone/Fax

Practice location:
  • Phone: 810-231-9042
  • Fax: 810-231-9063
Mailing address:
  • Phone: 810-231-9042
  • Fax: 810-231-9063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: