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General NPI Number Information
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NPI Number | 1467630111
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Entity Type | Individual
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Provider Name | NANCY TRUDEAU O.T., C.H.T.
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Gender | Female
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Dates
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Enumeration Date | 02/05/2008
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Last Update Date | 02/05/2008
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Provider Practice Location Address
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Address Line | 775 S MAIN ST
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City | CHELSEA
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State | MI
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Zip | 48118-1383
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Country | US
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Telephone | 734-475-4040
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Fax |
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Provider Business Mailing Address
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Address Line | 7107 AUTUMN WOOD DR
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City | BRIGHTON
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State | MI
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Zip | 48116-8289
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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 | 5201000151
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License Number State | MI
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