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NPI Code Detail

MEDICARE: DANIELLE LIZURA

MEDICARE:   DANIELLE  LIZURA
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
1225X00000XOccupational Therapist5201007614MI

General Provider Information

NPI Number : 1740779636
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE LIZURA
Provider Business Mailing Address
First Line : 39312 WOODWARD AVE
Second Line :
City : BLOOMFIELD HILLS
State : MI
Zip : 48304-5007
Country : US
Telephone Number : 248-644-5522
Fax Number :
Provider Business Practice Location Address
First Line : 39312 WOODWARD AVE
Second Line :
City : BLOOMFIELD HILLS
State : MI
Zip : 48304-5007
Country : US
Telephone Number : 248-644-5522
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2018
Last Update Date : 05/07/2018

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Directions to “ DANIELLE LIZURA ” Practice Location

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