Healthcare Provider Details

I. General information

NPI: 1497355770
Provider Name (Legal Business Name): MONICA MIKHAIL BA SOCIAL WORK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2020
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13101 ALLEN RD
SOUTHGATE MI
48195-2216
US

IV. Provider business mailing address

13101 ALLEN RD
SOUTHGATE MI
48195-2216
US

V. Phone/Fax

Practice location:
  • Phone: 248-885-3717
  • Fax:
Mailing address:
  • Phone: 248-885-3717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: