Provider Demographics
NPI:1992241459
Name:FARAH, LAMA SAMIR (SLP)
Entity type:Individual
Prefix:MRS
First Name:LAMA
Middle Name:SAMIR
Last Name:FARAH
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38777 6 MILE RD
Mailing Address - Street 2:SUITE 209, LIVONIA MI 48152
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-2694
Mailing Address - Country:US
Mailing Address - Phone:866-474-6677
Mailing Address - Fax:
Practice Address - Street 1:38777 6 MILE RD
Practice Address - Street 2:SUITE 209, LIVONIA MI 48152
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-2694
Practice Address - Country:US
Practice Address - Phone:866-474-6677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101005389235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist