Individual
SANDRA TARANTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21751 ECORSE RD, TAYLOR, MI 48180-1846
(313) 291-7000
(313) 291-0942
Mailing address
21751 ECORSE RD, TAYLOR, MI 48180-1846
(313) 291-7000
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
4704092811
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704092811
LICENSE
MI
Enumeration date
06/29/2006
Last updated
07/08/2007
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