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General NPI Number Information
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NPI Number | 1285393256
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Entity Type | Individual
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Provider Name | ALYSSA ROSE SLAKER OTRL
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Gender | Female
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Dates
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Enumeration Date | 12/16/2021
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 850 S HEWITT RD STE W
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City | YPSILANTI
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State | MI
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Zip | 48197-4594
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Country | US
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Telephone | 734-554-5561
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Fax |
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Provider Business Mailing Address
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Address Line | 9271 WESTBURY AVE
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City | PLYMOUTH
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State | MI
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Zip | 48170-4729
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Country | US
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Telephone | 734-679-1550
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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 | 5201012706
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License Number State | MI
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