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NPI Code Detail

MEDICARE: MARICELA TOMAS-MAZARIEGOS

MEDICARE: MARICELA TOMAS-MAZARIEGOS
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1134079585
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARICELA TOMAS-MAZARIEGOS
Provider Business Mailing Address
First Line : 29566 NORTHWESTERN HWY STE 100
Second Line :
City : SOUTHFIELD
State : MI
Zip : 48034-1036
Country : US
Telephone Number : 248-860-3490
Fax Number : 248-860-3490
Provider Business Practice Location Address
First Line : 29566 NORTHWESTERN HWY STE 100
Second Line :
City : SOUTHFIELD
State : MI
Zip : 48034-1036
Country : US
Telephone Number : 248-860-3490
Fax Number : 248-860-3490
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2026
Last Update Date : 02/03/2026

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Directions to “ MARICELA TOMAS-MAZARIEGOS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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