Provider Demographics
NPI:1265841779
Name:UHLEY, JOAN (OTR)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:
Last Name:UHLEY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15423 S BARTON LAKE DR
Mailing Address - Street 2:
Mailing Address - City:VICKSBURG
Mailing Address - State:MI
Mailing Address - Zip Code:49097-9775
Mailing Address - Country:US
Mailing Address - Phone:269-584-0085
Mailing Address - Fax:269-649-4647
Practice Address - Street 1:15423 S BARTON LAKE DR
Practice Address - Street 2:
Practice Address - City:VICKSBURG
Practice Address - State:MI
Practice Address - Zip Code:49097-9775
Practice Address - Country:US
Practice Address - Phone:269-584-0085
Practice Address - Fax:269-649-4647
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-08
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201000832225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist