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General NPI Number Information
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NPI Number | 1548702087
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Entity Type | Individual
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Provider Name | DARLENE DEMENIUK OT
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Gender | Female
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Dates
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Enumeration Date | 11/15/2016
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Last Update Date | 11/15/2016
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Provider Practice Location Address
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Address Line | 2305 GENOA BUSINESS PARK DR STE 170
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City | BRIGHTON
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State | MI
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Zip | 48114-7004
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Country | US
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Telephone | 810-299-8550
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Fax | 810-844-0837
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Provider Business Mailing Address
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Address Line | 6050 SHADOW PINES CT
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City | HOWELL
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State | MI
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Zip | 48843-7188
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Country | US
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Telephone | 517-376-6430
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Fax | 810-844-0837
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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 | 5201005659
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License Number State | MI
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