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General NPI Number Information
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NPI Number | 1992668560
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Entity Type | Individual
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Provider Name | SASHA MANOOGIAN
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Gender | Female
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 2470 COLLINGWOOD ST
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City | DETROIT
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State | MI
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Zip | 48206-1500
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Country | US
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Telephone | 586-260-7710
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Fax |
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Provider Business Mailing Address
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Address Line | 6279 SHADYDALE DR
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City | SHELBY TWP
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State | MI
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Zip | 48316-6306
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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