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:
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Health care specialties

SpecialtyCodeLicense #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 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679110480 NPPES
Michigan Other M242570730993 STATE ID

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