Healthcare Provider Details

I. General information

NPI: 1497621064
Provider Name (Legal Business Name): AYAH NAGA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 STEPHENSON HWY STE 200
TROY MI
48083-1132
US

IV. Provider business mailing address

550 STEPHENSON HWY STE 200
TROY MI
48083-1132
US

V. Phone/Fax

Practice location:
  • Phone: 248-585-3239
  • Fax:
Mailing address:
  • Phone: 248-585-3239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851120687
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: