Provider Demographics
NPI:1043327885
Name:SEITZ, SHARON LEE (OTR)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:LEE
Last Name:SEITZ
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MS
Other - First Name:SHARON
Other - Middle Name:LEE
Other - Last Name:PULJU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR
Mailing Address - Street 1:6655 JACKSON RD
Mailing Address - Street 2:LOT 639
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103
Mailing Address - Country:US
Mailing Address - Phone:734-995-6838
Mailing Address - Fax:734-995-6838
Practice Address - Street 1:5315 ELLIOTT DR
Practice Address - Street 2:STE 202
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197
Practice Address - Country:US
Practice Address - Phone:734-712-0600
Practice Address - Fax:734-712-0522
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
5201000681225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist