| Doctor Name: | MRS. SANITHA PULIKKOTIL |
| NPI Number: | 1003207648 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 6401014646 |
| Business Practice Address: | 175 N Groesbeck Hwy Unit 175-f Mount Clemens, MI - 480431562 |
| Business Phone Number: | 5866270024 |
| Business Fax Number: | |
| Mailing Address: | 2845 Tall Oaks Ct, Apt. 23 AUBURN HILLS |
| State: | MI |
| Postal Code: | 483264165 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 02/17/2015 |
| NPI Last Update Date: | 05/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 6401014646 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |