Provider Demographics
NPI:1851274864
Name:ISA, AMIRAH ALI
Entity type:Individual
Prefix:
First Name:AMIRAH
Middle Name:ALI
Last Name:ISA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROWAN
Other - Middle Name:AMIRAH-ALI
Other - Last Name:ISA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1500 S DOUGLAS RD STE 230
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4108
Mailing Address - Country:US
Mailing Address - Phone:844-244-1818
Mailing Address - Fax:
Practice Address - Street 1:29429 JOHN R RD
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-2565
Practice Address - Country:US
Practice Address - Phone:248-940-3592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-28
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician