Provider Demographics
NPI:1619744018
Name:AZAAD HEALING JUSTICE STUDIO
Entity Type:Organization
Organization Name:AZAAD HEALING JUSTICE STUDIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KULKIRAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:NAKAI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:312-909-2659
Mailing Address - Street 1:825 GROVE RD
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-6305
Mailing Address - Country:US
Mailing Address - Phone:312-909-2659
Mailing Address - Fax:
Practice Address - Street 1:825 GROVE RD
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-6305
Practice Address - Country:US
Practice Address - Phone:312-909-2659
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty