Provider Demographics
NPI:1922556406
Name:HAMEED, KENYA
Entity Type:Individual
Prefix:
First Name:KENYA
Middle Name:
Last Name:HAMEED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 BROOKVIEW CT
Mailing Address - Street 2:APT 201
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326
Mailing Address - Country:US
Mailing Address - Phone:201-956-3327
Mailing Address - Fax:
Practice Address - Street 1:111 EAST COURT ST
Practice Address - Street 2:SUITE 1B-1
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48502
Practice Address - Country:US
Practice Address - Phone:810-262-2320
Practice Address - Fax:810-239-1281
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301016816103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist