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General NPI Number Information
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NPI Number | 1235270869
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Entity Type | Individual
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Provider Name | MICHELLE LYNN MCGOWAN OT
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Gender | Female
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 29822 S WIXOM RD
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City | WIXOM
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State | MI
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Zip | 48393-3434
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Country | US
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Telephone | 248-926-5826
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Fax | 248-926-5830
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Provider Business Mailing Address
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Address Line | 9368 N LILLEY RD
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City | PLYMOUTH
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State | MI
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Zip | 48170-4610
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Country | US
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Telephone | 248-926-5826
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Fax | 248-926-5830
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5201005595
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License Number State | MI
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