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General NPI Number Information
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NPI Number | 1902312721
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Entity Type | Individual
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Provider Name | DANIELLE YOUNGSTON MOT, OTRL
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Gender | Female
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Dates
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Enumeration Date | 12/15/2017
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Last Update Date | 03/23/2023
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Provider Practice Location Address
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Address Line | 5655 CLARKSTON RD
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City | CLARKSTON
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State | MI
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Zip | 48348-3714
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Country | US
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Telephone | 810-618-1634
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Fax |
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Provider Business Mailing Address
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Address Line | 5365 APPLE HILL CT
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City | FLUSHING
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State | MI
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Zip | 48433-2401
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Country | US
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Telephone | 810-618-1634
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Fax |
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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 | 5201010070
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License Number State | MI
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