Provider Demographics
NPI:1669936316
Name:HIJAZI, KOWSAR A (PSYD, DLLP)
Entity type:Individual
Prefix:
First Name:KOWSAR
Middle Name:A
Last Name:HIJAZI
Suffix:
Gender:F
Credentials:PSYD, DLLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8184 WHITEFIELD ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-1121
Mailing Address - Country:US
Mailing Address - Phone:313-571-5198
Mailing Address - Fax:
Practice Address - Street 1:31478 INDUSTRIAL RD STE 300
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1840
Practice Address - Country:US
Practice Address - Phone:734-245-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6351004852103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical