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NPI Code Detail

MEDICARE: AZARI HAYGOOD MA, LLP

MEDICARE: AZARI HAYGOOD MA, 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
1103TC2200XClinical Child & Adolescent Psychologist6361008083MI

General Provider Information

NPI Number : 1730531039
Entity Type Code : Individual
Provider Name (Legal Business Name) : AZARI HAYGOOD MA, LLP
Provider Business Mailing Address
First Line : 32700 MARQUETTE ST
Second Line :
City : GARDEN CITY
State : MI
Zip : 48135-1232
Country : US
Telephone Number : 734-358-8002
Fax Number :
Provider Business Practice Location Address
First Line : 31557 SCHOOLCRAFT RD STE 200
Second Line :
City : LIVONIA
State : MI
Zip : 48150-1848
Country : US
Telephone Number : 734-474-2958
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2016
Last Update Date : 01/27/2025

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