Provider Demographics
NPI:1235842584
Name:OKANOVIC, ALMEDINA (COTA/L)
Entity Type:Individual
Prefix:
First Name:ALMEDINA
Middle Name:
Last Name:OKANOVIC
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40770 MAGNOLIA DR E
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-2592
Mailing Address - Country:US
Mailing Address - Phone:586-625-3785
Mailing Address - Fax:
Practice Address - Street 1:40770 MAGNOLIA DR E
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-2592
Practice Address - Country:US
Practice Address - Phone:586-625-3785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5202010006224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant