Provider Demographics
NPI:1821411646
Name:BAKHOYA, MARION
Entity type:Individual
Prefix:
First Name:MARION
Middle Name:
Last Name:BAKHOYA
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 1:180 ARBOR GLEN DR APT 301
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-8413
Mailing Address - Country:US
Mailing Address - Phone:248-974-1145
Mailing Address - Fax:
Practice Address - Street 1:180 ARBOR GLEN DR APT 301
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-8413
Practice Address - Country:US
Practice Address - Phone:248-974-1145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner