Provider Demographics
NPI:1407642960
Name:NURTURENEST PEDIATRIC THERAPY
Entity type:Organization
Organization Name:NURTURENEST PEDIATRIC THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEBA
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:BASHROUSH
Authorized Official - Suffix:
Authorized Official - Credentials:MASTERS
Authorized Official - Phone:313-404-3919
Mailing Address - Street 1:4845 HELEN ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-4117
Mailing Address - Country:US
Mailing Address - Phone:313-404-3919
Mailing Address - Fax:
Practice Address - Street 1:4845 HELEN ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-4117
Practice Address - Country:US
Practice Address - Phone:313-404-3919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-18
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty