Healthcare Provider Details

I. General information

NPI: 1467371773
Provider Name (Legal Business Name): ANNE GILLINGHAM OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 WEBER RD
SALINE MI
48176-9216
US

IV. Provider business mailing address

525 E MICHIGAN AVE STE 107
SALINE MI
48176-1588
US

V. Phone/Fax

Practice location:
  • Phone: 734-219-5030
  • Fax:
Mailing address:
  • Phone: 734-219-5030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5201005137
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: