Healthcare Provider Details

I. General information

NPI: 1861340978
Provider Name (Legal Business Name): BASMA HADDAD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2026
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1186 EAGLE NEST CT
MILFORD MI
48381-2730
US

IV. Provider business mailing address

1186 EAGLE NEST CT
MILFORD MI
48381-2730
US

V. Phone/Fax

Practice location:
  • Phone: 248-320-3740
  • Fax:
Mailing address:
  • Phone: 248-320-3740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. BASMA HADDAD
Title or Position: PSYCHOLOGIST
Credential: MA, LLP
Phone: 248-320-3740