Provider Demographics
NPI:1528257409
Name:HAMID, NIDA HALEEMA (PSYD)
Entity type:Individual
Prefix:DR
First Name:NIDA
Middle Name:HALEEMA
Last Name:HAMID
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3155 W BIG BEAVER RD STE 109
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-3006
Mailing Address - Country:US
Mailing Address - Phone:248-385-5756
Mailing Address - Fax:248-385-5758
Practice Address - Street 1:3155 W BIG BEAVER RD STE 109
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-3006
Practice Address - Country:US
Practice Address - Phone:248-385-5756
Practice Address - Fax:248-385-5758
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-17
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301014942103TC0700X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical