Healthcare Provider Details

I. General information

NPI: 1053215509
Provider Name (Legal Business Name): ISSA SPEECH THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 GOLFSIDE DR STE 6
ANN ARBOR MI
48108-1410
US

IV. Provider business mailing address

2900 GOLFSIDE DR STE 6
ANN ARBOR MI
48108-1410
US

V. Phone/Fax

Practice location:
  • Phone: 734-224-9121
  • Fax:
Mailing address:
  • Phone: 734-224-9121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: AHLAM ISSA
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential:
Phone: 734-224-9121