Individual provider · Type 1 NPI

Anna Jakovichtchouk

Student in an Organized Health Care Education/Training Program · Detroit, MI

NPI number 1629930631 Active

Practice location

4201 Saint Antoine St Ste 5B
Detroit, MI 48201-2153

Call (313) 996-0639 Map

Fax (313) 745-8165

Mailing address

29844 Mackenzie Cir W
Warren, MI 48092-3342

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1629930631

Anna Jakovichtchouk's National Provider Identifier is 1629930631, issued on Nov 27, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Detroit, MI. The record was last updated on Nov 27, 2025.