Provider Demographics
NPI:1518135615
Name:BATOR, CAROL BETH (OTR)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:BETH
Last Name:BATOR
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:BETH
Other - Last Name:LEVY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:9368 N LILLEY RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-4610
Mailing Address - Country:US
Mailing Address - Phone:734-416-3900
Mailing Address - Fax:734-453-2118
Practice Address - Street 1:9368 N LILLEY RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-4610
Practice Address - Country:US
Practice Address - Phone:734-416-3900
Practice Address - Fax:734-453-2118
Is Sole Proprietor?:No
Enumeration Date:2008-02-12
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201000853225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MICB0923OtherGROUP RR MEDICARE PIN
MI0N45090OtherMEDICARE GRP PIN
MI1518135615Medicaid
MICB0923OtherGROUP RR MEDICARE PIN