Provider Demographics
NPI:1497517080
Name:HIRSCH-OWENS, KAZAHJA
Entity Type:Individual
Prefix:
First Name:KAZAHJA
Middle Name:
Last Name:HIRSCH-OWENS
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 1:1110 MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48328-3834
Mailing Address - Country:US
Mailing Address - Phone:248-894-6632
Mailing Address - Fax:
Practice Address - Street 1:1110 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-3834
Practice Address - Country:US
Practice Address - Phone:248-894-6632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty