Provider Demographics
NPI:1801130570
Name:JAMALI, FARIDA NARGUESS (OTR/L)
Entity type:Individual
Prefix:
First Name:FARIDA
Middle Name:NARGUESS
Last Name:JAMALI
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 1:3916 MEADOWVIEW ST
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48144-9763
Mailing Address - Country:US
Mailing Address - Phone:734-854-1518
Mailing Address - Fax:
Practice Address - Street 1:5757 WHITEFORD RD
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-1632
Practice Address - Country:US
Practice Address - Phone:419-882-1875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT2730225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation