Provider Demographics
NPI:1568828028
Name:DEDONATIS, NADIA IOLANDA (PT,DPT)
Entity Type:Individual
Prefix:MS
First Name:NADIA
Middle Name:IOLANDA
Last Name:DEDONATIS
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33900 HARPER AVE
Mailing Address - Street 2:STE 104
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-4258
Mailing Address - Country:US
Mailing Address - Phone:248-353-1234
Mailing Address - Fax:248-353-1211
Practice Address - Street 1:37367 6 MILE RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-2775
Practice Address - Country:US
Practice Address - Phone:734-402-2335
Practice Address - Fax:734-402-2338
Is Sole Proprietor?:No
Enumeration Date:2016-01-13
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501017543225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist