Provider Demographics
NPI:1942870068
Name:SAKON, AMIAH LEIGH
Entity Type:Individual
Prefix:
First Name:AMIAH
Middle Name:LEIGH
Last Name:SAKON
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 1:100 E MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:STANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48888-8601
Mailing Address - Country:US
Mailing Address - Phone:989-372-9550
Mailing Address - Fax:
Practice Address - Street 1:100 E MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:STANTON
Practice Address - State:MI
Practice Address - Zip Code:48888-8601
Practice Address - Country:US
Practice Address - Phone:989-372-9550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician