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General NPI Number Information
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NPI Number | 1194647115
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Entity Type | Organization
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Legal Business Name | OLIVE BRANCH THERAPY
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Dates
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Enumeration Date | 07/29/2026
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Last Update Date | 07/29/2026
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Provider Practice Location Address
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Address Line | 10596 SCARLET OAK DR
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City | YPSILANTI
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State | MI
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Zip | 48198-1330
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Country | US
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Telephone | 734-891-0362
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Fax |
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Provider Business Mailing Address
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Address Line | 46036 MICHIGAN AVE
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City | CANTON
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State | MI
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Zip | 48188-2304
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | HANI MOHAMMED
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Credential | LMSW
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Telephone | 734-891-0362
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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