Basic Information
| Provider Information | |||||||||
| NPI: | 1922556406 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAMEED | ||||||||
| FirstName: | KENYA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 BROOKVIEW CT | ||||||||
| Address2: | APT 201 | ||||||||
| City: | AUBURN HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48326 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2019563327 | ||||||||
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| Practice Location | |||||||||
| Address1: | 111 EAST COURT ST | ||||||||
| Address2: | SUITE 1B-1 | ||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8102622320 | ||||||||
| FaxNumber: | 8102391281 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2016 | ||||||||
| LastUpdateDate: | 09/14/2016 | ||||||||
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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 | 103G00000X | 6301016816 | MI | Y | Behavioral Health & Social Service Providers | Clinical Neuropsychologist |
No ID Information.