Healthcare Provider Details

I. General information

NPI: 1841171733
Provider Name (Legal Business Name): KAMYA JABARI
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2025
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 W MARSHALL ST
FERNDALE MI
48220-2417
US

IV. Provider business mailing address

222 W MARSHALL ST
FERNDALE MI
48220-2417
US

V. Phone/Fax

Practice location:
  • Phone: 313-475-2047
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: