Individual provider · NPI-1

Mikaela Sade Ghani

Case Manager/Care Coordinator · Racine, WI

NPI number1649969783
StatusActive
Last updated in NPPESMay 4, 2023

Details

NPI
1649969783
Entity type
Individual (NPI-1)
Name
Mikaela Sade Ghani
Sex
Female
Sole proprietor
No
Enumeration date
May 4, 2023
Certification date
Apr 24, 2023
Last updated
May 4, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
171M00000X Case Manager/Care Coordinator––Yes
374U00000X Home Health Aide––

Practice location

2911 Durand Ave
Racine, WI 53402

Phone 262-498-3220

Mailing address

2911 Durand Ave
Racine, WI 53402

Phone 262-498-3220

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