Provider Demographics
NPI:1417490350
Name:BRIGGS, JUDITH LYNN (OTR)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:LYNN
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:BRIGGS
Other - Last Name:RAMHOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:22750 FOXCROFT ST
Mailing Address - Street 2:
Mailing Address - City:WOODHAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:48183-1429
Mailing Address - Country:US
Mailing Address - Phone:734-934-5135
Mailing Address - Fax:
Practice Address - Street 1:22750 FOXCROFT ST
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:MI
Practice Address - Zip Code:48183-1429
Practice Address - Country:US
Practice Address - Phone:734-934-5135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-26
Last Update Date:2016-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201002414225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist