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NPI Code Detail

MEDICARE: SHARICE BAUSLEY

MEDICARE: SHARICE BAUSLEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy Assistant5201007382MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104325240
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHARICE BAUSLEY
Provider Business Mailing Address
First Line : 10944 WORDEN ST
Second Line :
City : DETROIT
State : MI
Zip : 48224-1166
Country : US
Telephone Number : 313-469-4555
Fax Number :
Provider Business Practice Location Address
First Line : 111 FORD ST
Second Line :
City : HIGHLAND PARK
State : MI
Zip : 48203-3622
Country : US
Telephone Number : 313-883-3585
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2018
Last Update Date : 02/05/2018

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Directions to “ SHARICE BAUSLEY ” Practice Location

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