Healthcare Provider Details

I. General information

NPI: 1992609689
Provider Name (Legal Business Name): RAWAND CHALHOUB
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

5777 W MAPLE RD STE 100
WEST BLOOMFIELD MI
48322-2268
US

IV. Provider business mailing address

2001 HUBBELL ST
DEARBORN MI
48128-1327
US

V. Phone/Fax

Practice location:
  • Phone: 248-831-0838
  • Fax: 947-262-4965
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6362010389
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: