Healthcare Provider Details

I. General information

NPI: 1639370372
Provider Name (Legal Business Name): LINDA HUNTER-MILLAR CSA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 S PROSPECT ST
YPSILANTI MI
48198-7914
US

IV. Provider business mailing address

7945 FAIRCREST DR
YPSILANTI MI
48197-8354
US

V. Phone/Fax

Practice location:
  • Phone: 734-547-1113
  • Fax: 734-547-4795
Mailing address:
  • Phone: 734-547-1113
  • Fax: 734-547-4795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number907
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: