Healthcare Provider Details

I. General information

NPI: 1831011329
Provider Name (Legal Business Name): DARA SCARLETT ROSE MABIE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 CARE DR
HILLSDALE MI
49242-5054
US

IV. Provider business mailing address

88 S MANNING ST
HILLSDALE MI
49242-2013
US

V. Phone/Fax

Practice location:
  • Phone: 517-439-2641
  • Fax:
Mailing address:
  • Phone: 800-284-8288
  • Fax: 517-439-3339

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: