Healthcare Provider Details

I. General information

NPI: 1023291697
Provider Name (Legal Business Name): DEBORAH MARIE LOFTUS MOT,OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2007
Last Update Date: 01/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5840 INTERFACE DR STE 400
ANN ARBOR MI
48103-9176
US

IV. Provider business mailing address

42536 HAYES RD SUITE 100
CLINTON TOWNSHIP MI
48038-6766
US

V. Phone/Fax

Practice location:
  • Phone: 734-627-8001
  • Fax: 734-433-1989
Mailing address:
  • Phone: 586-286-9644
  • Fax: 586-286-9647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1123430
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: