Provider Demographics
NPI:1831809722
Name:MUHSEN, AYAH
Entity type:Individual
Prefix:
First Name:AYAH
Middle Name:
Last Name:MUHSEN
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 1:229 TIMBER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49006-4394
Mailing Address - Country:US
Mailing Address - Phone:910-224-8159
Mailing Address - Fax:
Practice Address - Street 1:229 TIMBER RIDGE DR APT SUITE
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49006-4394
Practice Address - Country:US
Practice Address - Phone:910-224-8159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011026133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered