Elise Renee Dirkse, OTR/L

Individual provider Active NPI Occupational Therapist · Jenison, MI

NPI 1114201449 · NPPES record last updated Oct 5, 2011

Key facts

NPI
1114201449
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
5201000987 (MI)
Practice address
7086 8TH Ave
Jenison, MI 49428-9352
Phone
(616) 667-9551
Fax
(616) 667-9552
NPI assigned
Oct 5, 2011
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5201000987 MI Yes

Addresses

Primary practice location

7086 8TH Ave
Jenison, MI 49428-9352

Mailing address

1074 28TH Ave
Hudsonville, MI 49426-9630
Phone (616) 896-6484

Other providers in Jenison, MI

All providers in Jenison, MI · Occupational Therapist in Michigan

Sources for this page

Verify at the official NPI Registry.