Lisa Michelle Glass, OTR
Individual provider Active NPI Gerontology Occupational Therapist · Plainwell, MI
NPI 1962980334 · NPPES record last updated Oct 24, 2024
Key facts
- NPI
- 1962980334
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gerontology Occupational Therapist 225XG0600X
- License
- 5201006690 (MI)
- Practice address
- 320 Brigham St
Plainwell, MI 49080-1587 - Phone
- (269) 685-9805
- NPI assigned
- Jul 29, 2018
- 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 |
|---|---|---|---|
| 5201006690 | MI | MD | Gerontology Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Occupational Therapist | 225XG0600X | |||
| Gerontology Occupational Therapist | 225XG0600X | 5201006690 | MI | Yes |
Addresses
Primary practice location
320 Brigham St
Plainwell, MI 49080-1587
Mailing address
65 2ND St
Plainwell, MI 49080-9550
Phone (734) 255-7056
Other practice location 1
42235 County Road 390
Bloomingdale, MI 49026-8753
Phone (269) 521-3383
Other providers in Plainwell, MI
- Rebecca Lyn Foster
- Stephen Keith Fuller
- Katie Galovan
- Michelle Lyn Gaudette
- Rachel Mary Giddings
- Allison Louise Gonzalez
- Nicholas James Grala
- Growing Motion Physical Therapy LLC
- David Lee Halley
- Bryan M Halverson
All providers in Plainwell, MI · Gerontology 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 Oct 24, 2024. 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.