Healthcare Provider Details

I. General information

NPI: 1235575077
Provider Name (Legal Business Name): SANDRA L TROPP MS. LLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2013
Last Update Date: 05/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1206 CLINTON RD
JACKSON MI
49202-2005
US

IV. Provider business mailing address

1206 CLINTON RD
JACKSON MI
49202-2005
US

V. Phone/Fax

Practice location:
  • Phone: 517-262-6853
  • Fax: 517-783-4164
Mailing address:
  • Phone: 517-262-6853
  • Fax: 517-783-4250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number6301008505
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6802009067
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: