Healthcare Provider Details

I. General information

NPI: 1669843454
Provider Name (Legal Business Name): LAILAH HAMED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2015
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6694 WOODEN SHOE CT
LIBERTY TOWNSHIP OH
45044-9731
US

IV. Provider business mailing address

6694 WOODEN SHOE CT
LIBERTY TOWNSHIP OH
45044-9731
US

V. Phone/Fax

Practice location:
  • Phone: 772-204-4913
  • Fax:
Mailing address:
  • Phone: 772-204-4913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number6627
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT011533
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: