MEDICARE: ZEINA ANGELA YAHFOUFI 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	103TC0700X	Clinical Psychologist	6361007793	MI

General Provider Information

NPI Number	:	1467237214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZEINA ANGELA YAHFOUFI LLP

Provider Business Mailing Address
First Line	:	30 BLAIR LN
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48120-1301
Country	:	US
Telephone Number	:	313-573-3758
Fax Number	:

Provider Business Practice Location Address
First Line	:	10500 SOUTHERN ST
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48126-3721
Country	:	US
Telephone Number	:	313-242-7162
Fax Number	:

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

Provider Enumeration Date	:	08/29/2023
Last Update Date	:	02/09/2026

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