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Individual

IKLAS JARJIS BASHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA

Contact information

Practice address
62 W 7 MILE RD, DETROIT, MI 48203-1967
(313) 893-6172
(313) 893-0064
Mailing address
62 W 7 MILE RD, DETROIT, MI 48203-1967
(313) 893-6172
(313) 893-0064

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401008658
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3434247
MI
Enumeration date
01/05/2007
Last updated
07/09/2007
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