Provider Demographics
NPI:1316490592
Name:ZUROFF, MIRIAM CEYNA (PHD)
Entity type:Individual
Prefix:
First Name:MIRIAM
Middle Name:CEYNA
Last Name:ZUROFF
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32255 NORTHWESTERN HWY STE 250
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-1527
Mailing Address - Country:US
Mailing Address - Phone:973-985-8646
Mailing Address - Fax:
Practice Address - Street 1:32255 NORTHWESTERN HWY STE 250
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1527
Practice Address - Country:US
Practice Address - Phone:973-985-8646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301014407103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist