Healthcare Provider Details

I. General information

NPI: 1659295830
Provider Name (Legal Business Name): SARA A SROUR LLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

25882 ORCHARD LAKE RD STE L-8
FARMINGTON HILLS MI
48336-1269
US

IV. Provider business mailing address

8254 ST JOHNS DR
WESTLAND MI
48185-4616
US

V. Phone/Fax

Practice location:
  • Phone: 313-364-9109
  • Fax:
Mailing address:
  • Phone: 313-364-9109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6362010420
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: