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General NPI Number Information
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NPI Number | 1306141510
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Entity Type | Organization
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Legal Business Name | DETROIT INSTITUTE FOR CHILDREN
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Dates
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Enumeration Date | 01/19/2011
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Last Update Date | 01/20/2011
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Provider Practice Location Address
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Address Line | 5447 WOODWARD AVE
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City | DETROIT
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State | MI
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Zip | 48202-4009
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Country | US
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Telephone | 313-832-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 5447 WOODWARD AVE
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City | DETROIT
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State | MI
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Zip | 48202-4009
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | HUMAN RESOURCE COORDINATOR
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Name | LUANN MURPHY
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Credential |
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Telephone | 313-578-4511
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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 | 5201007733
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License Number State | MI
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