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NPI Code Detail

MEDICARE: MAISSOUN KAMEL AWAD

MEDICARE:   MAISSOUN KAMEL AWAD
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
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1851879241
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAISSOUN KAMEL AWAD
Provider Business Mailing Address
First Line : 19853 OUTER DR
Second Line :
City : DEARBORN
State : MI
Zip : 48124-2066
Country : US
Telephone Number : 313-406-5056
Fax Number :
Provider Business Practice Location Address
First Line : 19853 OUTER DR
Second Line :
City : DEARBORN
State : MI
Zip : 48124-2066
Country : US
Telephone Number : 313-406-5056
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2018
Last Update Date : 01/19/2024

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Directions to “ MAISSOUN KAMEL AWAD ” Practice Location

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