Healthcare Provider Details

I. General information

NPI: 1629549795
Provider Name (Legal Business Name): BETHANY CLARE SCHULT MS,OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BETHANY CLARE BUROW MS, OTR/L

II. Dates (important events)

Enumeration Date: 12/16/2018
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 E JOLLY RD STE 210
LANSING MI
48910-6825
US

IV. Provider business mailing address

812 E JOLLY RD STE 210
LANSING MI
48910-6825
US

V. Phone/Fax

Practice location:
  • Phone: 517-237-7162
  • Fax:
Mailing address:
  • Phone: 517-237-7162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5201007517
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: