Healthcare Provider Details

I. General information

NPI: 1154256246
Provider Name (Legal Business Name): SARA HAK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22241 JOHN R RD
HAZEL PARK MI
48030-1716
US

IV. Provider business mailing address

2349 TALL OAKS DR
TROY MI
48098-2468
US

V. Phone/Fax

Practice location:
  • Phone: 248-336-0356
  • Fax:
Mailing address:
  • Phone: 248-535-4247
  • 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: