Provider Demographics
NPI:1538694831
Name:ROKOWSKY, SHAINA (MS,OT)
Entity Type:Individual
Prefix:
First Name:SHAINA
Middle Name:
Last Name:ROKOWSKY
Suffix:
Gender:F
Credentials:MS,OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25883 GREENFIELD RD
Mailing Address - Street 2:APT 36
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2113
Mailing Address - Country:US
Mailing Address - Phone:347-729-3165
Mailing Address - Fax:
Practice Address - Street 1:25883 GREENFIELD RD
Practice Address - Street 2:APT 36
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2113
Practice Address - Country:US
Practice Address - Phone:347-729-3165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-24
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201009568225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist