Individual
JENNA QASEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
229 N SHELDON RD, PLYMOUTH, MI 48170-1524
(313) 278-4601
Mailing address
229 N SHELDON RD, PLYMOUTH, MI 48170-1524
(313) 278-4601
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
235Z00000X
Speech-Language Pathologist
Primary
7101009125
MI
Other
Enumeration date
10/08/2019
Last updated
03/23/2026
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