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General NPI Number Information
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NPI Number | 1619703105
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Entity Type | Individual
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Provider Name | RILEY JANSSEN OTRL
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Gender | Female
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Dates
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Enumeration Date | 09/11/2024
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Last Update Date | 09/11/2024
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Provider Practice Location Address
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Address Line | 15500 19 MILE RD STE 330
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City | CLINTON TWP
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State | MI
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Zip | 48038-6313
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Country | US
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Telephone | 586-412-0016
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Fax | 586-412-0117
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Provider Business Mailing Address
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Address Line | 11878 HUBBARD ST STE 100
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City | LIVONIA
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State | MI
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Zip | 48150-1733
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Country | US
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Telephone | 734-743-2909
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Fax | 734-953-1743
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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 | 5201013983
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License Number State | MI
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