Individual
DALAL M HAIDOUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
10000 TELEGRAPH RD, TAYLOR, MI 48180-3330
(313) 295-6736
Mailing address
7541 ANDOVER DR, CANTON, MI 48187-1119
(313) 575-5555
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201008291
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487605168
—
MI
Enumeration date
02/22/2018
Last updated
02/22/2018
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