Provider Demographics
NPI:1083327233
Name:BARTOW, MYKEYA
Entity Type:Individual
Prefix:
First Name:MYKEYA
Middle Name:
Last Name:BARTOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23920 MIDDLEBELT RD APT 3308
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-2963
Mailing Address - Country:US
Mailing Address - Phone:313-753-1953
Mailing Address - Fax:
Practice Address - Street 1:501 W UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1944
Practice Address - Country:US
Practice Address - Phone:248-726-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician