Provider Demographics
NPI:1477321214
Name:HARON, MADISON CLAIRE
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:CLAIRE
Last Name:HARON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4023 JANICE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT GRATIOT
Mailing Address - State:MI
Mailing Address - Zip Code:48059-3770
Mailing Address - Country:US
Mailing Address - Phone:810-941-4936
Mailing Address - Fax:
Practice Address - Street 1:4023 JANICE AVE
Practice Address - Street 2:
Practice Address - City:FORT GRATIOT
Practice Address - State:MI
Practice Address - Zip Code:48059-3770
Practice Address - Country:US
Practice Address - Phone:810-941-4936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist