Provider Demographics
NPI:1275090268
Name:INDIVIDUALIZED QUALITY THERAPY LLC
Entity Type:Organization
Organization Name:INDIVIDUALIZED QUALITY THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SYDNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SABAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSOT, OTRL, CHT
Authorized Official - Phone:517-798-3677
Mailing Address - Street 1:836 CENTENNIAL WAY STE 160
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-8238
Mailing Address - Country:US
Mailing Address - Phone:517-798-3677
Mailing Address - Fax:517-539-6764
Practice Address - Street 1:836 CENTENNIAL WAY STE 160
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-8238
Practice Address - Country:US
Practice Address - Phone:517-798-3677
Practice Address - Fax:517-539-6764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-26
Last Update Date:2023-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty