Healthcare Provider Details

I. General information

NPI: 1972455707
Provider Name (Legal Business Name): THE REHAB MITTEN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43633 MICHIGAN AVE
CANTON MI
48188-2516
US

IV. Provider business mailing address

7606 N GULLEY RD
DEARBORN HEIGHTS MI
48127-3814
US

V. Phone/Fax

Practice location:
  • Phone: 313-740-0448
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: SONDOS IMAD JABER
Title or Position: OCCUPATIONAL THERAPIST
Credential: OTR/L
Phone: 313-740-0448