Individual
SANJA THELEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4080 BRISTOL DR, TROY, MI 48085-4809
(586) 873-2104
Mailing address
4080 BRISTOL DR, TROY, MI 48085-4809
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401018020
MI
Other
Enumeration date
01/19/2024
Last updated
05/28/2024
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