MEDICARE: MRS. RIAHANAH GAUSE M.S., LLP

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
1	103T00000X	Psychologist	6361008290	MI

General Provider Information

NPI Number	:	1134873557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RIAHANAH GAUSE M.S., LLP

Provider Business Mailing Address
First Line	:	11935 OLIVE ST
Second Line	:
City	:	ROMULUS
State	:	MI
Zip	:	48174-1239
Country	:	US
Telephone Number	:	734-846-0698
Fax Number	:

Provider Business Practice Location Address
First Line	:	650 LIVERNOIS ST
Second Line	:
City	:	FERNDALE
State	:	MI
Zip	:	48220-2304
Country	:	US
Telephone Number	:	313-595-8699
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2022
Last Update Date	:	01/06/2026

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Directions to “ MRS. RIAHANAH GAUSE M.S., LLP” Practice Location

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