Provider Demographics
NPI:1568889400
Name:DEGRAAF, CAROLINE (MS OTRL)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:
Last Name:DEGRAAF
Suffix:
Gender:F
Credentials:MS OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7225 N LUCE RD
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:MI
Mailing Address - Zip Code:48801-9691
Mailing Address - Country:US
Mailing Address - Phone:989-463-1730
Mailing Address - Fax:
Practice Address - Street 1:608 WRIGHT AVE
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1600
Practice Address - Country:US
Practice Address - Phone:989-463-4971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-27
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201000322225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist