Provider Demographics
NPI:1053207639
Name:SIDDQIUI, ZAINUB YASMEEN
Entity type:Individual
Prefix:
First Name:ZAINUB
Middle Name:YASMEEN
Last Name:SIDDQIUI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47442 MADISON RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-4701
Mailing Address - Country:US
Mailing Address - Phone:313-380-0480
Mailing Address - Fax:
Practice Address - Street 1:44560 FORD RD STE A
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-2944
Practice Address - Country:US
Practice Address - Phone:734-680-8780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician