Healthcare Provider Details

I. General information

NPI: 1679441471
Provider Name (Legal Business Name): HANNAH GRACE SKONEY-COURSEY
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2025
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 TOWN CENTER DR
TROY MI
48084-1774
US

IV. Provider business mailing address

210 TOWN CENTER DR
TROY MI
48084-1774
US

V. Phone/Fax

Practice location:
  • Phone: 248-643-8900
  • Fax:
Mailing address:
  • Phone: 248-643-8900
  • Fax: 248-643-8900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number5202010323
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: