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NPI Code Detail

MEDICARE: KAMILIA KHATIB-SHAHIDI

MEDICARE: KAMILIA KHATIB-SHAHIDI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1194659961
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAMILIA KHATIB-SHAHIDI
Provider Business Mailing Address
First Line : 23663 PARK ST
Second Line :
City : DEARBORN
State : MI
Zip : 48124-2547
Country : US
Telephone Number : 313-689-5188
Fax Number :
Provider Business Practice Location Address
First Line : 23663 PARK ST
Second Line :
City : DEARBORN
State : MI
Zip : 48124-2547
Country : US
Telephone Number : 313-689-5188
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2026
Last Update Date : 06/09/2026

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Directions to “ KAMILIA KHATIB-SHAHIDI ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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