Healthcare Provider Details

I. General information

NPI: 1952746265
Provider Name (Legal Business Name): RAJASHREE NATARAJAN AUD CCC-A INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2013
Last Update Date: 10/26/2016
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 Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number1601000395
License Number StateMI

VIII. Authorized Official

Name: DR. RAJASHREE NATARAJAN
Title or Position: DIRECTOR
Credential: AUD CCC-A
Phone: 248-449-6522