Healthcare Provider Details

I. General information

NPI: 1184695447
Provider Name (Legal Business Name): DONALD ALLEN MICHAEL LLMSW, OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3425 FRANCIS ST
JACKSON MI
49203-5052
US

IV. Provider business mailing address

3571 W BEAR LAKE RD
HILLSDALE MI
49242-9634
US

V. Phone/Fax

Practice location:
  • Phone: 517-782-2551
  • Fax: 517-783-1986
Mailing address:
  • Phone: 517-320-0600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT004093
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6851122429
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5201003897
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: