Healthcare Provider Details

I. General information

NPI: 1801603550
Provider Name (Legal Business Name): SARINE SABRINA MISIRLIYAN OTRL, OTD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2024
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33200 W 14 MILE RD STE 220
WEST BLOOMFIELD MI
48322-3586
US

IV. Provider business mailing address

PO BOX 23286
BELFAST ME
04915-4483
US

V. Phone/Fax

Practice location:
  • Phone: 248-595-7800
  • Fax: 248-630-7242
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5201014041
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: