Mousouleas, Mackenzie R
Mousouleas, Mackenzie R is an sole proprietor health care provider with primary practice located at 21267 Mayfair St , Woodhaven MI 48183-1609. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Mousouleas, Mackenzie R can be contacted via phone (734) 672-2933.Contact Information
Primary practice address
21267 Mayfair St
Woodhaven MI 48183-1609
Phone: (734) 672-2933
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X |
Profile Details
| NPI number | 1679110480 |
|---|---|
| LBN Legal business name | Mousouleas, Mackenzie R |
| Credentials | OTR/L |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 1st, 2019 |
| Last updated | Dec 1st, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679110480 | NPPES |
| Michigan | Other | M242570730993 | STATE ID |
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