Provider Demographics
NPI:1568519585
Name:FAOURI, FAIZEH ABDELKAREEM (PSYCHOLOGIST LLP)
Entity Type:Individual
Prefix:DR
First Name:FAIZEH
Middle Name:ABDELKAREEM
Last Name:FAOURI
Suffix:
Gender:F
Credentials:PSYCHOLOGIST LLP
Other - Prefix:
Other - First Name:FAIZEH
Other - Middle Name:ABDEL-KAREEM
Other - Last Name:ALFAOURI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:13229 E 12 MILE RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-3647
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8740 JOSEPH CAMPAU ST
Practice Address - Street 2:
Practice Address - City:HAMTRAMCK
Practice Address - State:MI
Practice Address - Zip Code:48212-3721
Practice Address - Country:US
Practice Address - Phone:313-875-4685
Practice Address - Fax:313-875-4701
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301013425103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3434247Medicaid