Provider Demographics
NPI:1588992499
Name:ABBO, BAN (MA, LLP)
Entity type:Individual
Prefix:MS
First Name:BAN
Middle Name:
Last Name:ABBO
Suffix:
Gender:
Credentials:MA, LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32910 W 13 MILE RD STE D-402
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-1980
Mailing Address - Country:US
Mailing Address - Phone:248-921-5945
Mailing Address - Fax:
Practice Address - Street 1:32910 W 13 MILE RD STE D-402
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1980
Practice Address - Country:US
Practice Address - Phone:248-921-5945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-04
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301012398103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist