Provider Demographics
NPI:1871523233
Name:MAJOR, SAUDIA (PHD)
Entity type:Individual
Prefix:DR
First Name:SAUDIA
Middle Name:
Last Name:MAJOR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 E CROSS ST
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-3908
Mailing Address - Country:US
Mailing Address - Phone:734-709-8618
Mailing Address - Fax:
Practice Address - Street 1:2215 FULLER RD # 11A
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-2303
Practice Address - Country:US
Practice Address - Phone:734-646-2910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7088103T00000X
MI6301013862103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL61-00808OtherHEALTH INSURANCE
FL359608OtherMHN
FL75009OtherHEALTH INSURANCE-HMO
FL359608OtherMHN