MEDICARE: NOORAYNE E CHEVALIER MA, LLP, CACII, CGC

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	103TC1900X	Counseling Psychologist	6301011017	MI

General Provider Information

NPI Number	:	1962705277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOORAYNE E CHEVALIER MA, LLP, CACII, CGC

Provider Business Mailing Address
First Line	:	19445 W WARREN AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48228-3361
Country	:	US
Telephone Number	:	313-307-0088
Fax Number	:	313-281-2235

Provider Business Practice Location Address
First Line	:	19445 W WARREN AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48228-3361
Country	:	US
Telephone Number	:	313-307-0088
Fax Number	:	313-281-2235

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

Provider Enumeration Date	:	12/08/2010
Last Update Date	:	04/20/2020

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Directions to “ NOORAYNE E CHEVALIER MA, LLP, CACII, CGC” Practice Location

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