Healthcare Provider Details

I. General information

NPI: 1457546806
Provider Name (Legal Business Name): SHASHA MARIA CAMAJ PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2007
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5340 PLYMOUTH RD STE 210
ANN ARBOR MI
48105-9559
US

IV. Provider business mailing address

3400 BURBANK DR
ANN ARBOR MI
48105-1594
US

V. Phone/Fax

Practice location:
  • Phone: 734-834-5777
  • Fax:
Mailing address:
  • Phone: 734-834-5777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301009569
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: