Basic Information
| Provider Information | |||||||||
| NPI: | 1164993713 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | PAPA | ||||||||
| FirstName: | KLODJANA | ||||||||
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| Credential: | OTRL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 443 KENSINGTON DR APT 177 | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483074060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5866048205 | ||||||||
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| Practice Location | |||||||||
| Address1: | 627 E MAPLE RD | ||||||||
| Address2: | |||||||||
| City: | TROY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480832812 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2485241912 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/07/2018 | ||||||||
| LastUpdateDate: | 12/07/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 5201010431 | MI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.