Healthcare Provider Details

I. General information

NPI: 1184538290
Provider Name (Legal Business Name): PEAS IN A POD PEDIATRIC THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 BYRON RD
HOWELL MI
48855-7751
US

IV. Provider business mailing address

3501 BYRON RD
HOWELL MI
48855-7751
US

V. Phone/Fax

Practice location:
  • Phone: 586-219-7734
  • Fax:
Mailing address:
  • Phone: 586-219-7734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARISSA ALFANO
Title or Position: SOCIAL WORKER
Credential: LMSW
Phone: 586-219-7734