Provider Demographics
NPI:1871202531
Name:MUSAIBLI, ASRA (MSCHMC)
Entity type:Individual
Prefix:
First Name:ASRA
Middle Name:
Last Name:MUSAIBLI
Suffix:
Gender:F
Credentials:MSCHMC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6450 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-2259
Mailing Address - Country:US
Mailing Address - Phone:313-216-2200
Mailing Address - Fax:
Practice Address - Street 1:6450 MAPLE ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-2259
Practice Address - Country:US
Practice Address - Phone:313-216-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451018788101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health