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General NPI Number Information
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NPI Number | 1558778134
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Entity Type | Individual
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Provider Name | SARAH JEAN KANABY LMSW
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Gender | Female
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Dates
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Enumeration Date | 07/16/2014
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Last Update Date | 06/14/2023
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Provider Practice Location Address
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Address Line | 35429 SCHOENHERR RD
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City | STERLING HEIGHTS
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State | MI
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Zip | 48312-4258
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Country | US
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Telephone | 586-303-2255
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Fax |
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Provider Business Mailing Address
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Address Line | 54036 SUTHERLAND LN
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48316-1248
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Country | US
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Telephone | 810-338-2038
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801095466
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License Number State | MI
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