Basic Information
| Provider Information | |||||||||
| NPI: | 1912044660 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CRONIN | ||||||||
| FirstName: | JANET | ||||||||
| MiddleName: | M. | ||||||||
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| Credential: | O.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4128 E GRAND RIVER AVE | ||||||||
| Address2: | |||||||||
| City: | HOWELL | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488436538 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5175401060 | ||||||||
| FaxNumber: | 5175401063 | ||||||||
| Practice Location | |||||||||
| Address1: | 4128 E GRAND RIVER AVE | ||||||||
| Address2: | |||||||||
| City: | HOWELL | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488436538 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5175401060 | ||||||||
| FaxNumber: | 5175401063 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2007 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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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 | 5201007071 | MI | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225XH1200X | 5201007071 | MI | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Hand |
ID Information
| ID | Type | State | Issuer | Description | 16869 | 01 | MI | M-CARE | OTHER | 500573 | 01 | MI | CARE CHOICES | OTHER | 7543420 | 01 | MI | AETNA | OTHER | P00100555 | 01 | MI | MEDICARE RAILROAD | OTHER | 0H20094 | 01 | MI | BCBS | OTHER | 0N58620 | 01 | MI | HAP | OTHER |