Healthcare Provider Details

I. General information

NPI: 1720994999
Provider Name (Legal Business Name): BIBI AISHA ALI
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20300 SUPERIOR RD STE 160
TAYLOR MI
48180-6341
US

IV. Provider business mailing address

29147 APPLEBLOSSOM LN
FARMINGTON HILLS MI
48331-2420
US

V. Phone/Fax

Practice location:
  • Phone: 888-622-3345
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6851122179
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: