Healthcare Provider Details

I. General information

NPI: 1649862368
Provider Name (Legal Business Name): MICHIGAN PEDIATRIC THERAPY PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2021
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27655 MIDDLEBELT RD STE 130
FARMINGTON HILLS MI
48334-5029
US

IV. Provider business mailing address

27655 MIDDLEBELT RD STE 130
FARMINGTON HILLS MI
48334-5029
US

V. Phone/Fax

Practice location:
  • Phone: 248-939-4030
  • Fax:
Mailing address:
  • Phone: 248-939-4030
  • Fax: 248-939-4698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MAGDA GIRAO
Title or Position: DIRECTOR
Credential: OTR
Phone: 248-939-4030