MEDICARE: JANELLE REHNLUND CORACE MSOTRL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1154537900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANELLE REHNLUND CORACE MSOTRL

Provider Business Mailing Address
First Line	:	1421 MIDLAND BLVD
Second Line	:
City	:	ROYAL OAK
State	:	MI
Zip	:	48073-2898
Country	:	US
Telephone Number	:	586-854-2039
Fax Number	:

Provider Business Practice Location Address
First Line	:	1421 MIDLAND BLVD
Second Line	:
City	:	ROYAL OAK
State	:	MI
Zip	:	48073-2898
Country	:	US
Telephone Number	:	586-854-2039
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	01/21/2015

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