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General NPI Number Information
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NPI Number | 1356823116
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Entity Type | Organization
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Legal Business Name | A1 OCCUPATIONAL THERAPY LLC
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Dates
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Enumeration Date | 08/29/2018
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Last Update Date | 08/29/2018
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Provider Practice Location Address
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Address Line | 23265 NORTHWESTERN HWY STE 200
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City | SOUTHFIELD
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State | MI
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Zip | 48075-7707
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Country | US
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Telephone | 248-996-9428
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Fax |
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Provider Business Mailing Address
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Address Line | 23265 NORTHWESTERN HWY STE 200
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City | SOUTHFIELD
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State | MI
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Zip | 48075-7707
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Country | US
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Telephone | 248-996-9428
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | JACQUELYN LUCIDO
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Credential | OTRL
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Telephone | 586-540-7193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number |
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License Number State |
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