Provider Demographics
NPI:1598044489
Name:BUSS, ALINA (MS/OTR/L)
Entity Type:Individual
Prefix:
First Name:ALINA
Middle Name:
Last Name:BUSS
Suffix:
Gender:F
Credentials:MS/OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49888 MEADOW OAK TRL
Mailing Address - Street 2:
Mailing Address - City:MATTAWAN
Mailing Address - State:MI
Mailing Address - Zip Code:49071-8617
Mailing Address - Country:US
Mailing Address - Phone:607-725-9443
Mailing Address - Fax:
Practice Address - Street 1:5659 STADIUM DR STE 2
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-1932
Practice Address - Country:US
Practice Address - Phone:269-372-0436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201013541225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist