Provider Demographics
NPI:1699005629
Name:DARYAEE, ROYA (AUD)
Entity Type:Individual
Prefix:
First Name:ROYA
Middle Name:
Last Name:DARYAEE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 E MAPLE RD
Mailing Address - Street 2:SUITE 400 - CREDENTIALING DEPARTMENT
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1138
Mailing Address - Country:US
Mailing Address - Phone:248-357-4151
Mailing Address - Fax:248-357-0229
Practice Address - Street 1:27117 LAHSER ROAD
Practice Address - Street 2:SUITE 203
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-8416
Practice Address - Country:US
Practice Address - Phone:248-357-4151
Practice Address - Fax:248-357-0229
Is Sole Proprietor?:No
Enumeration Date:2010-01-14
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000538231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist