Provider Demographics
NPI:1003177403
Name:NEUFELD, GAIL ANN (OTL)
Entity Type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:ANN
Last Name:NEUFELD
Suffix:
Gender:F
Credentials:OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20296 STATE HIGHWAY M203
Mailing Address - Street 2:
Mailing Address - City:CALUMET
Mailing Address - State:MI
Mailing Address - Zip Code:49913-9524
Mailing Address - Country:US
Mailing Address - Phone:906-337-5603
Mailing Address - Fax:
Practice Address - Street 1:850 W SHARON AVE STE 6
Practice Address - Street 2:
Practice Address - City:HOUGHTON
Practice Address - State:MI
Practice Address - Zip Code:49931-1968
Practice Address - Country:US
Practice Address - Phone:906-482-9363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-01
Last Update Date:2012-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201001722225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist