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General NPI Number Information
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NPI Number | 1659785046
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Entity Type | Individual
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Provider Name | MONICA MCCALLUM
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Gender | Female
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Dates
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Enumeration Date | 06/13/2014
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Last Update Date | 02/02/2023
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Provider Practice Location Address
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Address Line | 4380 FORD AVE
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City | LINDEN
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State | MI
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Zip | 48451-9189
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Country | US
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Telephone | 989-733-0028
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Fax |
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Provider Business Mailing Address
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Address Line | 16655 15 MILE RD SUITE B
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City | CLINTON TWP
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State | MI
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Zip | 48035-5522
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Country | US
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Telephone | 586-792-0970
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Fax | 586-792-0961
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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 | 5201008725
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License Number State | MI
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