Provider Demographics
NPI:1891503355
Name:DABAJA, HUSSEIN ALI (HIS)
Entity type:Individual
Prefix:
First Name:HUSSEIN
Middle Name:ALI
Last Name:DABAJA
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4884 E PICKARD ST STE C
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-2058
Mailing Address - Country:US
Mailing Address - Phone:989-953-7021
Mailing Address - Fax:989-755-0603
Practice Address - Street 1:4884 E PICKARD ST STE C
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-2058
Practice Address - Country:US
Practice Address - Phone:989-953-7021
Practice Address - Fax:989-755-0603
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3502013191237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist