Individual
ASHLEY RENEE WIDRIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5659 STADIUM DR, KALAMAZOO, MI 49009-1932
(693) 720-4436
(269) 372-0483
Mailing address
5659 STADIUM DR, KALAMAZOO, MI 49009-1932
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056010406
IL
225X00000X
Occupational Therapist
Primary
5201008692
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5201008692
STATE OF MICHIGAN
MI
Enumeration date
12/17/2013
Last updated
12/30/2021
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