Healthcare Provider Details

I. General information

NPI: 1568186385
Provider Name (Legal Business Name): MARIA EUGENIA SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2022
Last Update Date: 09/27/2022
Certification Date: 09/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51111 WOODWARD AVE STE 150
PONTIAC MI
48342-5037
US

IV. Provider business mailing address

35 ALPINE LN UNIT 140
PONTIAC MI
48340-1200
US

V. Phone/Fax

Practice location:
  • Phone: 248-977-5310
  • Fax:
Mailing address:
  • Phone: 248-254-2616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: