Healthcare Provider Details

I. General information

NPI: 1811816465
Provider Name (Legal Business Name): HEBAH H AHMED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5445 OAKMAN BLVD
DEARBORN MI
48126-3319
US

IV. Provider business mailing address

5445 OAKMAN BLVD
DEARBORN MI
48126-3319
US

V. Phone/Fax

Practice location:
  • Phone: 313-406-4586
  • Fax:
Mailing address:
  • Phone: 313-406-4586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number987456A
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number1234
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number5894
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: