Basic Information
Provider Information
NPI: 1932799095
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHARARA
FirstName: NAJLA
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: MSW INTERN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6601 FENTON ST
Address2:  
City: DEARBORN HEIGHTS
State: MI
PostalCode: 481272152
CountryCode: US
TelephoneNumber: 3133770037
FaxNumber:  
Practice Location
Address1: 9315 TELEGRAPH RD
Address2:  
City: REDFORD
State: MI
PostalCode: 482391260
CountryCode: US
TelephoneNumber: 3134504500
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/22/2021
LastUpdateDate: 01/22/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/22/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  Y Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


Home