Provider Demographics
NPI:1770175036
Name:SCHRAM, SECRET
Entity type:Individual
Prefix:
First Name:SECRET
Middle Name:
Last Name:SCHRAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SECRET
Other - Middle Name:
Other - Last Name:SCHRAM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:27777 INKSTER RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-5310
Mailing Address - Country:US
Mailing Address - Phone:517-213-9761
Mailing Address - Fax:
Practice Address - Street 1:27777 INKSTER RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-5310
Practice Address - Country:US
Practice Address - Phone:248-436-4354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-08
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No251E00000XAgenciesHome Health
No374U00000XNursing Service Related ProvidersHome Health Aide