Jordan Anderson

Individual provider Active NPI Occupational Therapist · Saint Joseph, MI

NPI 1003386269 · NPPES record last updated Nov 30, 2018

Key facts

NPI
1003386269
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
5201010227 (MI)
Practice address
1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone
(269) 983-8332
NPI assigned
Nov 30, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
5201010227MIMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5201010227 MI Yes

Addresses

Primary practice location

1234 Napier Ave
Saint Joseph, MI 49085-2112

Mailing address

1234 Napier Ave
Saint Joseph, MI 49085-2112

Other providers in Saint Joseph, MI

All providers in Saint Joseph, MI · Occupational Therapist in Michigan

Sources for this page

Verify at the official NPI Registry.