Individual
DR. KARISSA L. JAGACKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.,CCC-A
Contact information
Practice address
35337 WARREN RD, WESTLAND, MI 48185-2013
(734) 467-5100
(734) 467-5103
Mailing address
20956 OAK TREE DR, SOUTH LYON, MI 48178-7068
(248) 444-0674
(734) 467-5100
Taxonomy
Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
1601000113
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H10426
BLUE CARE NETWORK PIN
MI
05
—
4433772
—
MI
05
—
4704347
—
MI
01
—
540H104260
BCBS-HEARING AIDS
MI
01
—
640H227530
BCBS-SERVICES
MI
Enumeration date
09/15/2006
Last updated
05/01/2008
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