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General NPI Number Information
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NPI Number | 1134016900
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Entity Type | Individual
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Provider Name | RAZAN ELKHALI
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Gender |
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 30730 FORD RD
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City | GARDEN CITY
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State | MI
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Zip | 48135-1803
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Country | US
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Telephone | 313-254-2539
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Fax | 313-395-2198
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Provider Business Mailing Address
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Address Line | 20225 ANN ARBOR TRL
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-2690
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Country | US
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Telephone | 313-254-2539
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Fax | 313-395-2198
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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