Provider Demographics
NPI:1508303702
Name:SABAN, SYDNEY (MSOT, OTRL, CHT)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:SABAN
Suffix:
Gender:F
Credentials:MSOT, OTRL, CHT
Other - Prefix:
Other - First Name:SYDNEY
Other - Middle Name:
Other - Last Name:KELLOGG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2017-01-25
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI225X00000X
225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist