Healthcare Provider Details

I. General information

NPI: 1508915968
Provider Name (Legal Business Name): RAJASHREE NATARAJAN AUD CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 05/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25426 GODDARD RD
TAYLOR MI
48180-6200
US

IV. Provider business mailing address

47480 CHELTENHAM DR
NOVI MI
48374-3685
US

V. Phone/Fax

Practice location:
  • Phone: 313-295-4710
  • Fax: 313-295-4713
Mailing address:
  • Phone: 248-449-6522
  • Fax: 888-779-4701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1601000395
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: