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General NPI Number Information
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NPI Number | 1417374893
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Entity Type | Individual
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Provider Name | CHRISANN FAILING OTR
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Gender | Female
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Dates
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Enumeration Date | 03/24/2014
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Last Update Date | 06/27/2023
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Provider Practice Location Address
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Address Line | 3700 S HURON RD
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City | BAY CITY
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State | MI
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Zip | 48706-2065
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Country | US
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Telephone | 989-671-9866
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Fax |
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Provider Business Mailing Address
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Address Line | 3424 FAIRWAY DR
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City | BAY CITY
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State | MI
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Zip | 48706-3332
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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 |
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | 5201000627
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License Number State | MI
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