MEDICARE: ELIZABETH CATHERINE DENSLOW OTRL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	5201009951	MI

General Provider Information

NPI Number	:	1194228825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH CATHERINE DENSLOW OTRL

Provider Business Mailing Address
First Line	:	5867 W M 76
Second Line	:
City	:	WEST BRANCH
State	:	MI
Zip	:	48661-9619
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7376 GLEN EAGLE DR
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48706-9316
Country	:	US
Telephone Number	:	989-907-9533
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2018
Last Update Date	:	03/05/2025

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