Basic Information
| Provider Information | |||||||||
| NPI: | 1720481583 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KATTAN | ||||||||
| FirstName: | SUAD | ||||||||
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| Credential: | BSWLBSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20825 CASS | ||||||||
| Address2: | |||||||||
| City: | FAMINGTON HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48335 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2487970322 | ||||||||
| FaxNumber: | 2484760309 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 RIVER PLACE DR STE 250 | ||||||||
| Address2: | |||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482075402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3138712337 | ||||||||
| FaxNumber: | 3138716655 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/07/2014 | ||||||||
| LastUpdateDate: | 10/07/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 6802081552 | MI | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.