Individual
TRAVIS FAUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 HANCOCK ST, SAGINAW, MI 48602-4224
(989) 797-3565
Mailing address
2265 MARA DR, KAWKAWLIN, MI 48631-9448
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1750920740
MERCY PLUS
MI
Enumeration date
05/14/2021
Last updated
06/23/2023
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