Healthcare Provider Details

I. General information

NPI: 1376279521
Provider Name (Legal Business Name): NANCY SEBRING-CALE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2022
Last Update Date: 07/29/2022
Certification Date: 07/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5271 CHELSEA DR
HOLLY MI
48442-9656
US

IV. Provider business mailing address

411 E WARREN ST
MIDDLEBURY IN
46540-9546
US

V. Phone/Fax

Practice location:
  • Phone: 248-830-6872
  • Fax:
Mailing address:
  • Phone: 248-830-6871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number001536
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: