Provider Demographics
NPI:1487463063
Name:HANNAWI, YASMINE
Entity type:Individual
Prefix:
First Name:YASMINE
Middle Name:
Last Name:HANNAWI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:YASMINE
Other - Middle Name:
Other - Last Name:JAWAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:33900 HARPER AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-4258
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5688 N TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-3219
Practice Address - Country:US
Practice Address - Phone:313-633-9586
Practice Address - Fax:313-633-9589
Is Sole Proprietor?:No
Enumeration Date:2025-01-07
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501303667225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist