Healthcare Provider Details

I. General information

NPI: 1215406574
Provider Name (Legal Business Name): LINDA BAZZI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2018
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3290 W BIG BEAVER RD
TROY MI
48084-2903
US

IV. Provider business mailing address

3290 W BIG BEAVER RD STE 230
TROY MI
48084-2903
US

V. Phone/Fax

Practice location:
  • Phone: 248-299-0030
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801119015
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: