Provider Demographics
NPI:1215017074
Name:GARF, JUDITH M (OTR)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:M
Last Name:GARF
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:M
Other - Last Name:MENARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:15830 FORT ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195
Mailing Address - Country:US
Mailing Address - Phone:734-324-2980
Mailing Address - Fax:734-324-2981
Practice Address - Street 1:15830 FORT ST
Practice Address - Street 2:SUITE 6
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195
Practice Address - Country:US
Practice Address - Phone:734-324-2980
Practice Address - Fax:734-324-2981
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201002183225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P04090001Medicare ID - Type Unspecified