Michelle Outwater, OTR

Individual provider Active NPI Occupational Therapist · Ontonagon, MI

NPI 1386055044 · NPPES record last updated May 15, 2014

Key facts

NPI
1386055044
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
5201002667 (MI)
Practice address
114 Pennsylvania Ave
Apt 1
Ontonagon, MI 49953-1300
Phone
(269) 569-0402
NPI assigned
May 15, 2014
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
5201002667MIMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5201002667 MI Yes

Addresses

Primary practice location

114 Pennsylvania Ave
Apt 1
Ontonagon, MI 49953-1300

Mailing address

114 Pennsylvania Ave
Apt 1
Ontonagon, MI 49953-1300

Other providers in Ontonagon, MI

All providers in Ontonagon, MI · Occupational Therapist in Michigan

Sources for this page

Verify at the official NPI Registry.