=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548079270
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MORGAN J VASHER MSOT, OTRL
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/07/2025
-----------------------------------------------------
Last Update Date | 01/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2585 W HOUGHTON LAKE DR
-----------------------------------------------------
City | PRUDENVILLE
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48651-9624
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 989-366-2900
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10220 E GLADWIN RD
-----------------------------------------------------
City | GLADWIN
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48624-9315
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 989-256-2146
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | 5201014109
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------