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General NPI Number Information
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NPI Number | 1013716646
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Entity Type | Individual
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Provider Name | ELIZABETH MARIE MANSFIELD OTRL
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Gender | Female
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 347 CREEKSIDE DR
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City | PETOSKEY
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State | MI
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Zip | 49770-8676
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Country | US
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Telephone | 231-487-0080
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Fax |
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Provider Business Mailing Address
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Address Line | 915 ROBINSON ST UNIT 14
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City | BOYNE CITY
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State | MI
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Zip | 49712-9229
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Country | US
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Telephone | 231-373-6761
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XN1300X
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Taxonomy Name | Neurorehabilitation Occupational Therapist
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License Number | 5201014131
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License Number State | MI
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