Healthcare Provider Details

I. General information

NPI: 1407554165
Provider Name (Legal Business Name): YASMINE HAMADEH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2023
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29125 BUCKINGHAM ST STE 2A
LIVONIA MI
48154-4480
US

IV. Provider business mailing address

23663 PARK ST
DEARBORN MI
48124-2547
US

V. Phone/Fax

Practice location:
  • Phone: 734-744-4339
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number7401003443
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: