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General NPI Number Information
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NPI Number | 1265056394
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Entity Type | Organization
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Legal Business Name | SAKOON PSYCHOTHERAPY PLLC
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Dates
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Enumeration Date | 06/04/2020
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Last Update Date | 07/01/2020
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Provider Practice Location Address
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Address Line | 6512 N CANTON CENTER RD
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City | CANTON
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State | MI
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Zip | 48187-1652
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Country | US
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Telephone | 734-451-0600
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Fax | 734-451-0603
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Provider Business Mailing Address
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Address Line | 6512 N CANTON CENTER RD
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City | CANTON
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State | MI
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Zip | 48187-1652
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Country | US
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Telephone | 734-451-0600
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Fax | 734-451-0603
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Authorized Official
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Title or Position | OWNER
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Name | MARIAM F SAPARAMADU
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Credential | MSW
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Telephone | 734-451-0600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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