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General NPI Number Information
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NPI Number | 1992121990
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Entity Type | Individual
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Provider Name | ANA ASFAR
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Gender | Female
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Dates
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Enumeration Date | 03/14/2014
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Last Update Date | 03/14/2014
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Provider Practice Location Address
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Address Line | 201 W 7 MILE RD
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City | DETROIT
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State | MI
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Zip | 48203-1951
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Country | US
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Telephone | 313-366-0228
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Fax |
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Provider Business Mailing Address
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Address Line | 33231 KARIN DR APT 201
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City | STERLING HEIGHTS
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State | MI
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Zip | 48310-6283
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Country | US
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Telephone | 821-241-1921
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Fax |
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 171M00000X
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License Number State | MI
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