Provider Demographics
NPI:1437635083
Name:DOSS, RITA MARIE I (MSHA, OTRL)
Entity Type:Individual
Prefix:MRS
First Name:RITA
Middle Name:MARIE
Last Name:DOSS
Suffix:I
Gender:F
Credentials:MSHA, OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4350 STOCKEMER
Mailing Address - Street 2:
Mailing Address - City:WHITE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48383-1602
Mailing Address - Country:US
Mailing Address - Phone:248-308-0304
Mailing Address - Fax:
Practice Address - Street 1:10770 ELIZABETH LAKE RD
Practice Address - Street 2:
Practice Address - City:WHITE LAKE
Practice Address - State:MI
Practice Address - Zip Code:48386-2136
Practice Address - Country:US
Practice Address - Phone:248-618-4100
Practice Address - Fax:248-618-4265
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-17
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201004162225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty