Healthcare Provider Details

I. General information

NPI: 1346150414
Provider Name (Legal Business Name): HEATHER KIRSTEN DESROBERTS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 W KALAMAZOO ST
LANSING MI
48933-2080
US

IV. Provider business mailing address

5425 COPLEY SQUARE RD
GRAND BLANC MI
48439-8743
US

V. Phone/Fax

Practice location:
  • Phone: 517-755-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5201003860
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: