Andrea Wickham

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201007208 Issued in MI

Practice address

37623 Garfield Rd
Clinton Township, MI 48036-3673

Phone

(586) 295-5668

NPI assigned

Jun 14, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1174016042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 BEAUBIEN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37623 GARFIELD RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480363673",
            "telephone_number": "586-295-5668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3950 Beaubien St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012120",
            "country_code": "US",
            "telephone_number": "586-295-5668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WICKHAM",
        "first_name": "ANDREA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201007208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dwane White, LLMSW
• Tearani Latera White
• Matrina M Whitley, CRNA
• Paige N Whitmore
• James H Whitmyer, M.D.
• Madeline Marie Wideman, DPT
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• Kathryn Wiley
• Michelle Janine Wilhelm
• Courtney Willhite

• Occupational Therapist in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.