Provider Demographics
NPI:1578956348
Name:NASKI, NANCY JANE (MACTRS)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:JANE
Last Name:NASKI
Suffix:
Gender:F
Credentials:MACTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 HANNA ST
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009
Mailing Address - Country:US
Mailing Address - Phone:248-225-8521
Mailing Address - Fax:586-293-9167
Practice Address - Street 1:623 HANNA ST
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009
Practice Address - Country:US
Practice Address - Phone:248-225-8521
Practice Address - Fax:586-293-9150
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-18
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
24228OtherTHERAPEUTIC RECREATION CERT