Haider Hassan Al Darweesh

Individual provider Active NPI Cognitive & Behavioral Psychologist · Dexter, MI

NPI 1982134664 · NPPES record last updated Jan 7, 2021

Key facts

NPI
1982134664
Entity type
Individual (NPI type 1)
Primary specialty
Cognitive & Behavioral Psychologist 103TB0200X
License
6362009232 (MI)
Practice address
3258 Broad St Ste 2
Dexter, MI 48130-1142
Phone
(734) 664-2528
NPI assigned
Jun 15, 2017
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
6362009232MIMDCognitive & Behavioral Psychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician
Group: 193400000X SINGLE SPECIALTY GROUP
106S00000X
Cognitive & Behavioral Psychologist 103TB0200X 6362009232 MI Yes

Addresses

Primary practice location

3258 Broad St Ste 2
Dexter, MI 48130-1142

Mailing address

23400 Michigan Ave Ste
Dearborn, MI 48124

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL Dexter Direct

Other providers in Dexter, MI

All providers in Dexter, MI · Cognitive & Behavioral Psychologist in Michigan

Sources for this page

Verify at the official NPI Registry.