Provider Demographics
NPI:1598752321
Name:SAVICH, TATJANA TINA (OTR)
Entity Type:Individual
Prefix:MS
First Name:TATJANA
Middle Name:TINA
Last Name:SAVICH
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42536 HAYES RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-6766
Mailing Address - Country:US
Mailing Address - Phone:586-286-9644
Mailing Address - Fax:586-286-9647
Practice Address - Street 1:42536 HAYES RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-6766
Practice Address - Country:US
Practice Address - Phone:586-286-9644
Practice Address - Fax:586-286-9647
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201003790225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N718600Medicare ID - Type UnspecifiedMEDICARE GROUP
MI0N71810Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE