| Sprouted Sage Llc | |
|
300 N 5th Ave Ste 210 Ann Arbor MI 48104-1447 | |
| (734) 222-9277 | |
| Not Available |
| Full Name | Sprouted Sage Llc |
|---|---|
| Speciality | Psychologist - Clinical Child & Adolescent |
| Location | 300 N 5th Ave Ste 210, Ann Arbor, Michigan |
| Authorized Official Name and Position | Suzi Naguib (CLINICAL DIRECTOR) |
| Authorized Official Contact | 7342229277 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sprouted Sage Llc 300 N 5th Ave Ste 210 Ann Arbor MI 48104-1447 Ph: () - | Sprouted Sage Llc 300 N 5th Ave Ste 210 Ann Arbor MI 48104-1447 Ph: (734) 222-9277 |
| NPI Number | 1235703257 |
|---|---|
| Provider Enumeration Date | 05/14/2021 |
| Last Update Date | 05/14/2021 |
| Certification Date | 05/07/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235703257 | NPI | - | NPPES |
| 12311188 | Other | CAQH ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | (* (Not Available)) | Primary |
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