Individual
JESSICA ELLINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L CBIS
Contact information
Practice address
3181 SANDHILL RD, MASON, MI 48854-9425
(517) 336-6060
(517) 336-6050
Mailing address
3181 SANDHILL RD, MASON, MI 48854-9425
(517) 336-6060
(517) 336-6050
Taxonomy
Speciality
Code
Description
License number
State
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
5201008424
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
305197
NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY
—
01
—
5201008424
OCCUPATIONAL THERAPIST LICENSE
MI
Enumeration date
04/14/2015
Last updated
02/08/2019
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