Organization
NEUROCOGNITIVE CENTER OF MICHIGAN GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MOHAMAD K ALTABBA MBA (PRESIDENT/DIRECTOR)
(586) 582-0500
Entity
Organization
Contact information
Practice address
28800 RYAN RD, SUITE 300, WARREN, MI 48092-4272
(586) 582-0500
(586) 620-8113
Mailing address
28800 RYAN RD, SUITE 300, WARREN, MI 48092-4272
(586) 582-0500
(586) 620-8113
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
03/11/2015
Last updated
03/11/2015
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