Healthcare Provider Details

I. General information

NPI: 1164335576
Provider Name (Legal Business Name): SARAB KAMOO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18871 SARATOGA BLVD
LATHRUP VILLAGE MI
48076-7816
US

IV. Provider business mailing address

18871 SARATOGA BLVD
LATHRUP VILLAGE MI
48076-7816
US

V. Phone/Fax

Practice location:
  • Phone: 248-470-4306
  • Fax:
Mailing address:
  • Phone: 248-470-4306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number6801067091
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: