Healthcare Provider Details

I. General information

NPI: 1194472902
Provider Name (Legal Business Name): SARAH TOMAKICH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2022
Last Update Date: 03/02/2022
Certification Date: 02/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2272 E MICHIGAN AVE SUITE 223
LANSING MI
48912
US

IV. Provider business mailing address

2272 E MICHIGAN AVE SUITE 223
LANSING MI
48912
US

V. Phone/Fax

Practice location:
  • Phone: 231-534-5432
  • Fax:
Mailing address:
  • Phone: 231-534-5432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: VALERIE ALEXANDER
Title or Position: BILLER
Credential:
Phone: 616-735-1505