Provider Demographics
NPI:1083480248
Name:BITAR, ALI
Entity Type:Individual
Prefix:
First Name:ALI
Middle Name:
Last Name:BITAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2395 S HURON PKWY
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-5170
Mailing Address - Country:US
Mailing Address - Phone:734-882-2833
Mailing Address - Fax:734-822-0237
Practice Address - Street 1:2395 S HURON PKWY
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-5170
Practice Address - Country:US
Practice Address - Phone:734-882-2833
Practice Address - Fax:734-822-0237
Is Sole Proprietor?:No
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician