Provider Demographics
NPI:1396417739
Name:BARAKAT, AMNEE IBRAHIM (OTR/L)
Entity Type:Individual
Prefix:
First Name:AMNEE
Middle Name:IBRAHIM
Last Name:BARAKAT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 N RIVER ST APT 5
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-4035
Mailing Address - Country:US
Mailing Address - Phone:734-582-3002
Mailing Address - Fax:
Practice Address - Street 1:223 N RIVER ST APT 5
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-4035
Practice Address - Country:US
Practice Address - Phone:734-582-3002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT011725225X00000X
SCOT.6318225X00000X
MI5201011404225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist