Koiki Xan Hallberg, OTR
Individual provider Active NPI Occupational Therapist · Ortonville, MI
NPI 1962633552 · NPPES record last updated Apr 27, 2015
Key facts
- NPI
- 1962633552
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 5201004539 (MI)
- Practice address
- 1999 Oakwood Rd
Ortonville, MI 48462-8536 - Phone
- (248) 627-2177
- NPI assigned
- Jul 31, 2009
- 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)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5201004539 | MI | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 5201004539 | MI | Yes |
Addresses
Primary practice location
1999 Oakwood Rd
Ortonville, MI 48462-8536
Mailing address
1999 Oakwood Rd
Ortonville, MI 48462-8536
Phone (248) 627-2177
Other providers in Ortonville, MI
- Melissa Danielle Gomoll
- Ladonna J. Gordon
- Nancy Ann Gorelick
- Ruchita Talshibhai Goyani
- Lynette Marie Griffin
- Angela Lynn Harrell
- Royann Marie Hassinger
- Susan A Hawley
- Janet Delores Heasley
- Elena Guadalupe Hopkins
All providers in Ortonville, MI · Occupational Therapist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 27, 2015. 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.