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General NPI Number Information
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NPI Number | 1952172652
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Entity Type | Individual
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Provider Name | JODI BEINTEMA
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Gender | Female
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Dates
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Enumeration Date | 01/11/2024
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 2000 32ND ST SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49508-7910
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Country | US
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Telephone | 616-452-5900
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Fax |
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Provider Business Mailing Address
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Address Line | 871 WOODSPOINTE DR SW
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City | BYRON CENTER
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State | MI
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Zip | 49315-8221
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Country | US
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Telephone |
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 5202006714
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License Number State | MI
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