Basic Information
| Provider Information | |||||||||
| NPI: | 1972094555 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SEARCY | ||||||||
| FirstName: | KRISTIN | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3890 PRESCOTT ST | ||||||||
| Address2: | |||||||||
| City: | HAMTRAMCK | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482123116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3135858157 | ||||||||
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| Practice Location | |||||||||
| Address1: | 12575 TELEGRAPH RD | ||||||||
| Address2: | |||||||||
| City: | TAYLOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481804019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7342874710 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2018 | ||||||||
| LastUpdateDate: | 05/19/2018 | ||||||||
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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 | 5201008780 | MI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.