Provider Demographics
NPI:1477534410
Name:SENSORY SYSTEMS CLINIC PC
Entity Type:Organization
Organization Name:SENSORY SYSTEMS CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:GLOVAK
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:586-293-7553
Mailing Address - Street 1:30801 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48082-1732
Mailing Address - Country:US
Mailing Address - Phone:586-293-7553
Mailing Address - Fax:586-293-5827
Practice Address - Street 1:30801 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48082-1732
Practice Address - Country:US
Practice Address - Phone:586-293-7553
Practice Address - Fax:586-293-5827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty