Healthcare Provider Details

I. General information

NPI: 1083453930
Provider Name (Legal Business Name): DASIANAY NI'KEYA WARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2024
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31275 NORTHWESTERN HWY STE 203
FARMINGTON HILLS MI
48334-2579
US

IV. Provider business mailing address

31275 NORTHWESTERN HWY STE 203
FARMINGTON HILLS MI
48334-2579
US

V. Phone/Fax

Practice location:
  • Phone: 313-583-7422
  • Fax:
Mailing address:
  • Phone: 313-583-7422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851118155
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: