Provider Demographics
NPI:1033542352
Name:WILLEMIN, DENISE (OTR/L)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:WILLEMIN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27751 NANTICOKE RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-1647
Mailing Address - Country:US
Mailing Address - Phone:816-799-1862
Mailing Address - Fax:
Practice Address - Street 1:27751 NANTICOKE RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-1647
Practice Address - Country:US
Practice Address - Phone:816-799-1862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-11
Last Update Date:2013-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06578225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist