Healthcare Provider Details

I. General information

NPI: 1689579914
Provider Name (Legal Business Name): SARAH AYOUB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17200 W OUTER DR STE A
DEARBORN HEIGHTS MI
48127-2457
US

IV. Provider business mailing address

26637 GOLFVIEW ST
DEARBORN HEIGHTS MI
48127-1645
US

V. Phone/Fax

Practice location:
  • Phone: 313-278-4601
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: