Provider Demographics
NPI:1134646094
Name:TROMPETER, JEANNE MARIE (MS, OTRL)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:MARIE
Last Name:TROMPETER
Suffix:
Gender:F
Credentials:MS, OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5376 GLEN HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-9535
Mailing Address - Country:US
Mailing Address - Phone:1269-823-2789
Mailing Address - Fax:
Practice Address - Street 1:145 S MAIN ST STE 4
Practice Address - Street 2:
Practice Address - City:WAYLAND
Practice Address - State:MI
Practice Address - Zip Code:49348-1702
Practice Address - Country:US
Practice Address - Phone:269-792-2353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201009895225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist