Provider Demographics
NPI:1154489862
Name:NAIDU, MEENA
Entity Type:Individual
Prefix:
First Name:MEENA
Middle Name:
Last Name:NAIDU
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 1:37799 PROFESSIONAL CENTER DR STE 103
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-1123
Mailing Address - Country:US
Mailing Address - Phone:734-942-7660
Mailing Address - Fax:734-942-7662
Practice Address - Street 1:37799 PROFESSIONAL CENTER DR STE 103
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-1123
Practice Address - Country:US
Practice Address - Phone:734-942-7660
Practice Address - Fax:734-942-7662
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI104100000X, 235Z00000X
MI200638791225100000X, 225X00000X, 374U00000X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No374U00000XNursing Service Related ProvidersHome Health Aide