Provider Demographics
NPI: | 1790301158 |
---|---|
Name: | CASSINI, SUHILA (AROMATHERAPY PRACT) |
Entity Type: | Individual |
Prefix: | PROF |
First Name: | SUHILA |
Middle Name: | |
Last Name: | CASSINI |
Suffix: | |
Gender: | F |
Credentials: | AROMATHERAPY PRACT |
Other - Prefix: | DR |
Other - First Name: | SUHILA |
Other - Middle Name: | |
Other - Last Name: | ABUIJHESHIA |
Other - Suffix: | |
Other - Last Name Type: | Professional Name |
Other - Credentials: | PHYSICIAN HEALER |
Mailing Address - Street 1: | 3297 ORCHARD LAKE RD STE 107 |
Mailing Address - Street 2: | |
Mailing Address - City: | KEEGO HARBOR |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 48320-1378 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 248-800-0828 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 3297 ORCHARD LAKE RD |
Practice Address - Street 2: | STE 107 |
Practice Address - City: | KEEGO HARBOR |
Practice Address - State: | MI |
Practice Address - Zip Code: | 48320 |
Practice Address - Country: | US |
Practice Address - Phone: | 248-800-0828 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2020-06-22 |
Last Update Date: | 2020-06-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
101Y00000X, 133VN1201X, 172V00000X, 174400000X, 225400000X, 225700000X, 225A00000X, 3747P1801X, 374T00000X, 133VN1004X | ||
CA | 102X00000X | |
MI | 2705004591 | 207R00000X, 207Q00000X, 2083P0901X, 2084A2900X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 133VN1004X | Dietary & Nutritional Service Providers | Dietitian, Registered | Nutrition, Pediatric |
No | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | |
No | 102X00000X | Behavioral Health & Social Service Providers | Poetry Therapist | |
No | 133VN1201X | Dietary & Nutritional Service Providers | Dietitian, Registered | Nutrition, Obesity and Weight Management |
No | 172V00000X | Other Service Providers | Community Health Worker | |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | |
No | 174400000X | Other Service Providers | Specialist | |
No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | |
No | 2083P0901X | Allopathic & Osteopathic Physicians | Preventive Medicine | Public Health & General Preventive Medicine |
No | 2084A2900X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurocritical Care |
No | 225400000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Practitioner | |
No | 225700000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist | |
No | 225A00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Music Therapist | |
No | 3747P1801X | Nursing Service Related Providers | Technician | Personal Care Attendant |
No | 374T00000X | Nursing Service Related Providers | Religious Nonmedical Nursing Personnel |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MI | 2705004591 | Other | ALL PROVIDERS LISTED USE PROFESSIONAL LICENSE ID 2705004591 |