Provider Demographics
NPI:1437731411
Name:MUSBACH, SAVANNA MARIE (CFLE)
Entity Type:Individual
Prefix:MS
First Name:SAVANNA
Middle Name:MARIE
Last Name:MUSBACH
Suffix:
Gender:F
Credentials:CFLE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41521 W 11 MILE RD
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-1803
Mailing Address - Country:US
Mailing Address - Phone:269-370-5525
Mailing Address - Fax:
Practice Address - Street 1:3300 LANSING AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-1621
Practice Address - Country:US
Practice Address - Phone:517-784-2929
Practice Address - Fax:517-784-3030
Is Sole Proprietor?:No
Enumeration Date:2021-04-28
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician