Healthcare Provider Details

I. General information

NPI: 1386571701
Provider Name (Legal Business Name): JODDY R PRAET
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28175 HAGGERTY RD
NOVI MI
48377-2903
US

IV. Provider business mailing address

28175 HAGGERTY RD
NOVI MI
48377-2903
US

V. Phone/Fax

Practice location:
  • Phone: 248-994-4317
  • Fax: 248-994-4317
Mailing address:
  • Phone: 248-994-4317
  • Fax: 248-994-4317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: