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General NPI Number Information
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NPI Number | 1982595146
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Entity Type | Individual
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Provider Name | MCKENZIE ANN PETERS OTD, OTRL
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Gender | Female
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Dates
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Enumeration Date | 07/14/2025
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 635 S MAPLE RD STE 2
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City | ANN ARBOR
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State | MI
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Zip | 48103-3838
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Country | US
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Telephone | 734-369-6002
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Fax | 734-315-0426
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Provider Business Mailing Address
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Address Line | 312 AVE DE LAFAYETTE
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City | MONROE
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State | MI
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Zip | 48162-3559
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Country | US
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Telephone | 734-625-1786
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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 | 5201014266
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License Number State | MI
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