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General NPI Number Information
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NPI Number | 1538708680
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Entity Type | Individual
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Provider Name | CAYLIE HOSEY CTRS
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Gender | Female
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Dates
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Enumeration Date | 01/06/2020
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Last Update Date | 01/06/2020
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Provider Practice Location Address
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Address Line | 54749 FLAMINGO DR
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City | SHELBY TWP
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State | MI
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Zip | 48315-1347
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Country | US
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Telephone | 586-441-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 39393 VAN DYKE AVE STE 105
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City | STERLING HEIGHTS
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State | MI
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Zip | 48313-4636
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225800000X
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Taxonomy Name | Recreation Therapist
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License Number | 82716
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License Number State | MI
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