Healthcare Provider Details

I. General information

NPI: 1174433858
Provider Name (Legal Business Name): ANIYA ADAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 E 11 MILE RD
WARREN MI
48092-2878
US

IV. Provider business mailing address

11361 WARWICK ST
DETROIT MI
48228-1370
US

V. Phone/Fax

Practice location:
  • Phone: 586-250-2271
  • Fax:
Mailing address:
  • Phone: 313-569-7063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: