Individual
SHAIMA ALTAYIB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA, LBA
Contact information
Practice address
1360 PORTER ST, DEARBORN, MI 48124-2890
(313) 689-5188
Mailing address
5939 OAKMAN BLVD, DEARBORN, MI 48126-2388
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
7401001657
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
06/18/2018
Last updated
10/24/2022
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