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NPI Code Detail

MEDICARE: MRS. SHEILA MARY MALONE OTR

MEDICARE: MRS. SHEILA MARY MALONE OTR
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
1225X00000XOccupational Therapist5201002219MI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10N45090OTHERMIMEDICARE GRP PTAN

General Provider Information

NPI Number : 1588670640
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHEILA MARY MALONE OTR
Provider Business Mailing Address
First Line : 42615 GARFIELD ROAD
Second Line :
City : CLINTON TOWNSHIP
State : MI
Zip : 48038
Country : US
Telephone Number : 586-412-2846
Fax Number : 586-412-7087
Provider Business Practice Location Address
First Line : 29600 WIXOM RD
Second Line :
City : WIXOM
State : MI
Zip : 48393-3430
Country : US
Telephone Number : 248-960-1600
Fax Number : 248-960-9755
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2006
Last Update Date : 05/19/2008

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Directions to “ MRS. SHEILA MARY MALONE OTR” Practice Location

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