Provider Demographics
NPI:1407092422
Name:AZUH, MARGARET (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:
Last Name:AZUH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:
Other - Last Name:UKPONU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4737 3RD ST
Mailing Address - Street 2:APT 6
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-3743
Mailing Address - Country:US
Mailing Address - Phone:313-530-3853
Mailing Address - Fax:
Practice Address - Street 1:11000 W MCNICHOLS RD
Practice Address - Street 2:SUITE 301
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48221-2357
Practice Address - Country:US
Practice Address - Phone:313-530-3853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-22
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2-00795101YA0400X
MI6401010444101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)