Provider Demographics
NPI:1518766591
Name:HIJAZI, FATIMA (OTD, OTRL)
Entity type:Individual
Prefix:
First Name:FATIMA
Middle Name:
Last Name:HIJAZI
Suffix:
Gender:
Credentials:OTD, OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5736 WILLIAMSON ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-2170
Mailing Address - Country:US
Mailing Address - Phone:734-353-7201
Mailing Address - Fax:
Practice Address - Street 1:37650 PROFESSIONAL CENTER DR STE 105A
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-1199
Practice Address - Country:US
Practice Address - Phone:734-943-4848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201014202225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist