Healthcare Provider Details

I. General information

NPI: 1285376160
Provider Name (Legal Business Name): MICHAELA RAYANNE KUHLMAN MSOT, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHAELA SLONE MSOT, OTR/L

II. Dates (important events)

Enumeration Date: 04/11/2022
Last Update Date: 11/28/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9368 N LILLEY RD
PLYMOUTH MI
48170-4610
US

IV. Provider business mailing address

9368 N LILLEY RD
PLYMOUTH MI
48170-4610
US

V. Phone/Fax

Practice location:
  • Phone: 734-416-3900
  • Fax: 734-453-2118
Mailing address:
  • Phone: 734-416-3900
  • Fax: 734-453-2118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5201012896
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: