Lynn Marie Ellsworth, COTA/L
Individual provider Active NPI Occupational Therapy Assistant · Whitehall, MI
NPI 1467011908 · NPPES record last updated Jun 9, 2019
Key facts
- NPI
- 1467011908
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 5202007777 (MI)
- Practice address
- 7598 Durham Rd
Whitehall, MI 49461-9513 - Phone
- (231) 730-5348
- NPI assigned
- Jun 9, 2019
- 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)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5202007777 | MI | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 5202007777 | MI | Yes |
Addresses
Primary practice location
7598 Durham Rd
Whitehall, MI 49461-9513
Mailing address
7598 Durham Rd
Whitehall, MI 49461-9513
Phone (231) 730-5348
Other providers in Whitehall, MI
- Dignity Dunes in Home Care and Consulting LLC
- Anthony James Donley
- Ashleigh Mae Durek
- Desiree Lee Elliot
- Nathan Leroy Elliott
- Kerri Forbear
- Sarah Louise Fouser
- Michelle Gillan
- Grant Kurtis Gillish
- Jamie Gonder
All providers in Whitehall, MI · Occupational Therapy Assistant in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.