Individual
SARA JEAN KADISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
279 SUMMIT DR, WATERFORD, MI 48328-3364
(248) 724-7600
Mailing address
47735 RED RUN DR, CANTON, MI 48187-5491
(734) 394-6348
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
284142987
BEHAVIOR ANALYST
NY
Enumeration date
12/13/2021
Last updated
12/28/2022
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