MEDICARE: BOGDANA DARCOHE

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	225XN1300X	Neurorehabilitation Occupational Therapist

General Provider Information

NPI Number	:	1245897958
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BOGDANA DARCOHE

Provider Business Mailing Address
First Line	:	12524 MORAN ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48212-2329
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	464 E GRAND BLVD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48207-3637
Country	:	US
Telephone Number	:	313-850-7365
Fax Number	:

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

Provider Enumeration Date	:	05/29/2019
Last Update Date	:	05/29/2019

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Directions to “ BOGDANA DARCOHE ” Practice Location

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