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Individual

ELANA FACKLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5333 MCAULEY DR RM 2110, YPSILANTI, MI 48197-1097
(734) 712-3967
Mailing address
3110 ASHTON BROOKE DR APT 6, BEAVERCREEK, OH 45431-8889

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
03/22/2022
Last updated
03/22/2022
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