Healthcare Provider Details

I. General information

NPI: 1164989422
Provider Name (Legal Business Name): ALL IN ONE THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2019
Last Update Date: 02/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29688 TELEGRAPH RD STE 400
SOUTHFIELD MI
48034-1364
US

IV. Provider business mailing address

29688 TELEGRAPH RD STE 400
SOUTHFIELD MI
48034-1364
US

V. Phone/Fax

Practice location:
  • Phone: 248-884-0048
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. AMY REZVAN
Title or Position: CEO
Credential:
Phone: 248-884-0048