Provider Demographics
NPI:1366644015
Name:MOHSIN, NOSHABA
Entity Type:Individual
Prefix:
First Name:NOSHABA
Middle Name:
Last Name:MOHSIN
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 1:23300 PROVIDENCE DR
Mailing Address - Street 2:104
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-3652
Mailing Address - Country:US
Mailing Address - Phone:248-760-4281
Mailing Address - Fax:248-624-9081
Practice Address - Street 1:23300 PROVIDENCE DR
Practice Address - Street 2:104
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3652
Practice Address - Country:US
Practice Address - Phone:248-760-4281
Practice Address - Fax:248-624-9081
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist