Provider Demographics
NPI:1427503226
Name:SWEET, JAMIE (LMT)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:SWEET
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 N LEROY ST
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-2760
Mailing Address - Country:US
Mailing Address - Phone:810-522-4540
Mailing Address - Fax:844-558-9767
Practice Address - Street 1:1220 N LEROY ST
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-2760
Practice Address - Country:US
Practice Address - Phone:810-522-4540
Practice Address - Fax:844-558-9767
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-22
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501004632173000000X, 225700000X
MI374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No173000000XOther Service ProvidersLegal Medicine
No374J00000XNursing Service Related ProvidersDoula