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General NPI Number Information
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NPI Number | 1306740253
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Entity Type | Organization
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Legal Business Name | SHINE ON THE SPECTRUM
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 48751 STRUCTURAL DR
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City | CHESTERFIELD
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State | MI
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Zip | 48051-2664
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Country | US
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Telephone | 586-248-1241
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Fax |
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Provider Business Mailing Address
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Address Line | 48751 STRUCTURAL DR
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City | CHESTERFIELD
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State | MI
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Zip | 48051-2664
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Country | US
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Telephone | 586-248-1241
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HEIDI PICKFORD
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Credential | OTR/L
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Telephone | 586-248-1241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number |
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License Number State | NULL
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