Provider Demographics
NPI:1407137136
Name:RENTA, MAGEN MICHELE (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MAGEN
Middle Name:MICHELE
Last Name:RENTA
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:MISS
Other - First Name:MAGEN
Other - Middle Name:MICHELE
Other - Last Name:RIGSBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3605 RATLIFF RD
Mailing Address - Street 2:THERAPY DEPT.
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35210-4512
Mailing Address - Country:US
Mailing Address - Phone:205-956-2184
Mailing Address - Fax:205-956-2195
Practice Address - Street 1:3605 RATLIFF RD
Practice Address - Street 2:THERAPY DEPT.
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35210-4512
Practice Address - Country:US
Practice Address - Phone:205-956-2184
Practice Address - Fax:205-956-2195
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2722225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist