Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | B10001020 | DE |
N | 103TC0700X | Clinical Psychologist | B10001020 | DE |
Y | 103G00000X | Clinical Psychologist | 6301018421 | MI |
Y | 103TC0700X | Clinical Psychologist | 6301018421 | MI |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | B10001020 | DE |
NPI | 1063890192 |
---|---|
Provider Name | Maya Zayat |
First Address | Southfield, MI 48033-3849 |
Second Address | Royal Oak, MI 48073-6710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2015 |
Last Update Date | 01/12/2020 |