Provider Demographics
NPI:1740598168
Name:ASHRAFIOUN, CHRISTINA MARIA (AUD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:MARIA
Last Name:ASHRAFIOUN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:CHRISTINA
Other - Middle Name:MARIA
Other - Last Name:DAMBRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:3621 SOUTH STATE STREET
Mailing Address - Street 2:700 KMS PLACE
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108
Mailing Address - Country:US
Mailing Address - Phone:734-936-2047
Mailing Address - Fax:
Practice Address - Street 1:19900 HAGGERTY RD
Practice Address - Street 2:STE 111
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152
Practice Address - Country:US
Practice Address - Phone:734-432-7811
Practice Address - Fax:734-432-7822
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002318-1231H00000X
MI1601000626231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1346285657Medicaid
NY1346285657Medicaid