Provider Demographics
NPI:1518156678
Name:ZAVERZENCE-VENETTIS, MICHELE C (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:C
Last Name:ZAVERZENCE-VENETTIS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:27450 SCHOENHERR RD
Mailing Address - Street 2:SUITE 100 A
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-6683
Mailing Address - Country:US
Mailing Address - Phone:586-582-7825
Mailing Address - Fax:586-582-7917
Practice Address - Street 1:27450 SCHOENHERR RD
Practice Address - Street 2:SUITE 100 A
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-6683
Practice Address - Country:US
Practice Address - Phone:582-586-7825
Practice Address - Fax:582-586-7826
Is Sole Proprietor?:No
Enumeration Date:2007-10-15
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201000667225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI230195Medicare PIN