Healthcare Provider Details

I. General information

NPI: 1386049724
Provider Name (Legal Business Name): NADIA HABHAB PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2014
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 CLAREMONT ST
DEARBORN MI
48124-1305
US

IV. Provider business mailing address

26400 LAHSER RD STE 220
SOUTHFIELD MI
48033-2674
US

V. Phone/Fax

Practice location:
  • Phone: 313-500-2368
  • Fax:
Mailing address:
  • Phone: 248-354-8460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number6301015509
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301019088
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: