Healthcare Provider Details

I. General information

NPI: 1396040846
Provider Name (Legal Business Name): CRIBS AND BIBS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2011
Last Update Date: 01/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19639 W 12 MILE RD APT 203
SOUTHFIELD MI
48076-2550
US

IV. Provider business mailing address

19639 W 12 MILE RD APT 203
SOUTHFIELD MI
48076-2550
US

V. Phone/Fax

Practice location:
  • Phone: 313-595-7266
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE DAYS
Title or Position: CEO
Credential:
Phone: 313-595-7266