Healthcare Provider Details

I. General information

NPI: 1619831575
Provider Name (Legal Business Name): ROWAN ALHENEYNIE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23500 PARK ST # 3B
DEARBORN MI
48124-2598
US

IV. Provider business mailing address

6309 HORGER ST
DEARBORN MI
48126-2226
US

V. Phone/Fax

Practice location:
  • Phone: 313-694-7700
  • Fax:
Mailing address:
  • Phone: 313-888-7336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: