Individual
AMANI FADLALLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5286 WILLIAMSON, DEARBORN, MI 48126
(313) 584-3740
Mailing address
5286 WILLIAMSON ST, DEARBORN, MI 48126-5002
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301016473
MI
103T00000X
Psychologist
6361005138
MI
103TC0700X
Clinical Psychologist
6301016473
MI
103TC0700X
Clinical Psychologist
6361005138
MI
Other
Enumeration date
11/05/2015
Last updated
08/05/2022
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