Healthcare Provider Details

I. General information

NPI: 1164351904
Provider Name (Legal Business Name): DONNA J. CASE OTL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8390 CHUBB RD
NORTHVILLE MI
48168-9608
US

IV. Provider business mailing address

8390 CHUBB RD
NORTHVILLE MI
48168-9608
US

V. Phone/Fax

Practice location:
  • Phone: 248-719-0434
  • Fax:
Mailing address:
  • Phone: 248-719-0434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number5201001950
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: