Healthcare Provider Details

I. General information

NPI: 1477418044
Provider Name (Legal Business Name): JENNA SALMONI OTRL
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

261 MACK AVE
DETROIT MI
48201-2417
US

IV. Provider business mailing address

10919 BALFOUR AVE
ALLEN PARK MI
48101-1162
US

V. Phone/Fax

Practice location:
  • Phone: 313-966-8309
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number5201010527
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: