Provider Demographics
NPI:1578922480
Name:ZAIAT, MARIAM (OTRL)
Entity Type:Individual
Prefix:
First Name:MARIAM
Middle Name:
Last Name:ZAIAT
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9357 GENERAL DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-4662
Mailing Address - Country:US
Mailing Address - Phone:734-454-0866
Mailing Address - Fax:
Practice Address - Street 1:9357 GENERAL DR
Practice Address - Street 2:SUITE 101
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-4662
Practice Address - Country:US
Practice Address - Phone:734-454-0866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-19
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201007619225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics