Healthcare Provider Details

I. General information

NPI: 1740074574
Provider Name (Legal Business Name): ANNA GRZENIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 04/07/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 STATE ST
SAGINAW MI
48603-3490
US

IV. Provider business mailing address

12145 GRATIOT RD
SAGINAW MI
48609-9653
US

V. Phone/Fax

Practice location:
  • Phone: 989-401-2244
  • Fax:
Mailing address:
  • Phone:
  • 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: