Healthcare Provider Details

I. General information

NPI: 1134789514
Provider Name (Legal Business Name): CYNTHIA GUZI CTRS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2019
Last Update Date: 06/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4469 LUTZ DR
WARREN MI
48092-1750
US

IV. Provider business mailing address

4469 LUTZ DR
WARREN MI
48092-1750
US

V. Phone/Fax

Practice location:
  • Phone: 586-216-7213
  • Fax:
Mailing address:
  • Phone: 586-216-7213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: