Provider Demographics
NPI:1467837211
Name:ABDULHAQQ, AMINAH (CDCD)
Entity Type:Individual
Prefix:MRS
First Name:AMINAH
Middle Name:
Last Name:ABDULHAQQ
Suffix:
Gender:F
Credentials:CDCD
Other - Prefix:
Other - First Name:JUWAIRRIYAH
Other - Middle Name:
Other - Last Name:ABDULHAQQ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CHEMICAL DEPENDENCY
Mailing Address - Street 1:7800 DETROIT AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-2814
Mailing Address - Country:US
Mailing Address - Phone:216-939-3734
Mailing Address - Fax:
Practice Address - Street 1:7800 DETROIT AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-2814
Practice Address - Country:US
Practice Address - Phone:216-939-3734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-22
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH121562101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)