Healthcare Provider Details

I. General information

NPI: 1528929635
Provider Name (Legal Business Name): SARA TIWANA BS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2025
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 INDUSTRIAL DR
OWOSSO MI
48867-9775
US

IV. Provider business mailing address

1555 INDUSTRIAL DR
OWOSSO MI
48867-9775
US

V. Phone/Fax

Practice location:
  • Phone: 989-723-6791
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: