Provider Demographics
NPI:1649419680
Name:LABOVE, KARREN JAYE (OT)
Entity Type:Individual
Prefix:
First Name:KARREN
Middle Name:JAYE
Last Name:LABOVE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47035 BARBARA RD
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-2406
Mailing Address - Country:US
Mailing Address - Phone:586-362-5554
Mailing Address - Fax:
Practice Address - Street 1:47035 BARBARA RD
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-2406
Practice Address - Country:US
Practice Address - Phone:586-362-5554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-16
Last Update Date:2009-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112868225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist