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NPI Code Detail

MEDICARE: SARA SHAEFF

MEDICARE: SARA SHAEFF
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 TechnicianRBT-16-24664MI
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1952766586
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA SHAEFF
Provider Business Mailing Address
First Line : 30330 HICKEY RD
Second Line :
City : CHESTERFIELD
State : MI
Zip : 48051-3911
Country : US
Telephone Number : 586-421-4062
Fax Number :
Provider Business Practice Location Address
First Line : 30330 HICKEY RD
Second Line :
City : CHESTERFIELD
State : MI
Zip : 48051-3911
Country : US
Telephone Number : 586-421-4062
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/26/2015
Last Update Date : 04/12/2022

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Directions to “ SARA SHAEFF ” Practice Location

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