Provider Demographics
NPI:1770255382
Name:ISSA SPEECH THERAPY PLLC
Entity type:Organization
Organization Name:ISSA SPEECH THERAPY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:AHLAM ISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ISSA
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:734-945-9628
Mailing Address - Street 1:2900 GOLFSIDE DR STE 6
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-1410
Mailing Address - Country:US
Mailing Address - Phone:734-224-9121
Mailing Address - Fax:
Practice Address - Street 1:2900 GOLFSIDE DR STE 6
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-1410
Practice Address - Country:US
Practice Address - Phone:734-224-9121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-01
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech