Provider Demographics
NPI:1407987365
Name:KRAFT-GUILFOYLE, DORLAH CARLEEN (OTR/L CLT)
Entity Type:Individual
Prefix:MS
First Name:DORLAH
Middle Name:CARLEEN
Last Name:KRAFT-GUILFOYLE
Suffix:
Gender:F
Credentials:OTR/L CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 BEECH ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48813-1016
Mailing Address - Country:US
Mailing Address - Phone:517-543-2940
Mailing Address - Fax:517-541-2098
Practice Address - Street 1:530 BEECH ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:MI
Practice Address - Zip Code:48813-1016
Practice Address - Country:US
Practice Address - Phone:517-543-2940
Practice Address - Fax:517-541-2098
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05891225XH1200X
MI5201005212225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand