Healthcare Provider Details

I. General information

NPI: 1366933459
Provider Name (Legal Business Name): ANNA MIAH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2018
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 S MAIN ST STE 260
PLYMOUTH MI
48170-2089
US

IV. Provider business mailing address

705 S MAIN ST STE 260
PLYMOUTH MI
48170-2089
US

V. Phone/Fax

Practice location:
  • Phone: 734-441-0553
  • Fax:
Mailing address:
  • Phone: 734-441-0553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: