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1770618449 NPI number — SIMONE A. NAKFOOR OTR/L

NPI Number: 1770618449
Health Care Provider/Practitioner: SIMONE A. NAKFOOR OTR/L

Information about “1770618449” NPI (SIMONE A. NAKFOOR OTR/L) exists in 1770618449 in HTML format HTML  |  1770618449 in plain Text format TXT  |  1770618449 in PDF (Portable Document Format) PDF  |  1770618449 in an XML format XML  formats.

NPI Number : 1770618449 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1770618449",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "NAKFOOR",
    "FirstName": "SIMONE",
    "MiddleName": "A.",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "OTR/L",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ANAYA-NAKFOOR",
    "OtherFirstName": "SIMONE",
    "OtherMiddleName": "A",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "OTR/L",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "12200 BROADBENT RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LANSING",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48917-9706",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "517-731-6200",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1101 CINDY DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LANSING",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48917-9239",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "480-227-0853",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/22/2007",
    "LastUpdateDate": "03/18/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "225XN1300X",
          "TaxonomyName": "Neurorehabilitation Occupational Therapist",
          "LicenseNumber": "1797",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225XP0200X",
          "TaxonomyName": "Pediatric Occupational Therapist",
          "LicenseNumber": "1797",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225XP0019X",
          "TaxonomyName": "Physical Rehabilitation Occupational Therapist",
          "LicenseNumber": "5201013759",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "225X00000X",
          "TaxonomyName": "Occupational Therapist",
          "LicenseNumber": "1797",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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