MEDICARE: LANA HASSAN SERHAN

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
1	106S00000X	Behavior Technician	S900000807033	MI

General Provider Information

NPI Number	:	1295678167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LANA HASSAN SERHAN

Provider Business Mailing Address
First Line	:	5981 FENTON ST
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48127-3271
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	23500 PARK ST # 3B
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48124-2598
Country	:	US
Telephone Number	:	313-694-7700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2026
Last Update Date	:	04/14/2026

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Directions to “ LANA HASSAN SERHAN ” Practice Location

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