Rachel Booth

Individual provider Active NPI Occupational Therapist · Davison, MI

NPI 1861963902 · NPPES record last updated Dec 16, 2018

Key facts

NPI
1861963902
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
5201009048 (MI)
Practice address
1515 Cal Dr
Davison, MI 48423-9016
Phone
(517) 449-9984
NPI assigned
Dec 16, 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
5201009048MIMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5201009048 MI Yes

Addresses

Primary practice location

1515 Cal Dr
Davison, MI 48423-9016

Mailing address

4335 Knollwood Dr
Grand Blanc, MI 48439-2028

Other identifiers

IdentifierTypeStateIssuer
N299853MedicaidMI

Other providers in Davison, MI

All providers in Davison, MI · Occupational Therapist in Michigan

Sources for this page

Verify at the official NPI Registry.