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NPI Code Detail

MEDICARE: DR. SYEDA YASMEEN MOHAMMAD PSY.D.LP

MEDICARE:  DR. SYEDA YASMEEN MOHAMMAD  PSY.D.LP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist63-01-009113MI

General Provider Information

NPI Number : 1053336396
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SYEDA YASMEEN MOHAMMAD PSY.D.LP
Provider Business Mailing Address
First Line : 6223 N CANTON CENTER RD
Second Line : SUITE NUMBER 210
City : CANTON
State : MI
Zip : 48187-2696
Country : US
Telephone Number : 734-737-1200
Fax Number : 734-737-1205
Provider Business Practice Location Address
First Line : 6223 N CANTON CENTER RD
Second Line : SUITE NUMBER 210
City : CANTON
State : MI
Zip : 48187-2696
Country : US
Telephone Number : 734-737-1200
Fax Number : 734-737-1205
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2006
Last Update Date : 07/08/2007

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