Provider Demographics
NPI:1538918651
Name:KARUNARAJ, SHAILA
Entity type:Individual
Prefix:
First Name:SHAILA
Middle Name:
Last Name:KARUNARAJ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47475 CASA LOMA CT
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48167-5829
Mailing Address - Country:US
Mailing Address - Phone:248-385-8431
Mailing Address - Fax:
Practice Address - Street 1:29226 ORCHARD LAKE RD STE 100
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3046
Practice Address - Country:US
Practice Address - Phone:248-450-5853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician