Healthcare Provider Details

I. General information

NPI: 1235063439
Provider Name (Legal Business Name): MOLLY BRIDGET BOYLE VELDHEER OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 3 MILE RD NW
GRAND RAPIDS MI
49544-1650
US

IV. Provider business mailing address

1000 3 MILE RD NW
GRAND RAPIDS MI
49544-1650
US

V. Phone/Fax

Practice location:
  • Phone: 616-327-6191
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5201014676
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: