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General NPI Number Information
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NPI Number | 1275295032
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Entity Type | Individual
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Provider Name | JOCELYN DEE MCGINNIS OTR/L
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Gender | Female
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Dates
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Enumeration Date | 10/08/2021
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Last Update Date | 10/08/2021
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Provider Practice Location Address
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Address Line | 2420 COIT AVE NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49505-4001
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Country | US
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Telephone | 556-461-6635
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Fax |
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Provider Business Mailing Address
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Address Line | 156 MANZANA CT NW APT 2B
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City | GRAND RAPIDS
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State | MI
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Zip | 49534-5750
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Country | US
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Telephone | 231-942-3168
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5201011402
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License Number State | MI
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