Provider Demographics
NPI:1215792031
Name:ABOUKHODR, ZAHRAA
Entity type:Individual
Prefix:
First Name:ZAHRAA
Middle Name:
Last Name:ABOUKHODR
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 1:23916 MICHIGAN AVE
Mailing Address - Street 2:STE 150
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124
Mailing Address - Country:US
Mailing Address - Phone:313-221-9218
Mailing Address - Fax:
Practice Address - Street 1:23916 MICHIGAN AVE
Practice Address - Street 2:STE 150
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124
Practice Address - Country:US
Practice Address - Phone:313-221-9218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator