Provider Demographics
NPI:1689820102
Name:TUELL, ADITI (MS, OTR/L, CHT, CLT)
Entity Type:Individual
Prefix:MS
First Name:ADITI
Middle Name:
Last Name:TUELL
Suffix:
Gender:F
Credentials:MS, OTR/L, CHT, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1814 OAKLAND DR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-1854
Mailing Address - Country:US
Mailing Address - Phone:732-516-8208
Mailing Address - Fax:
Practice Address - Street 1:5659 STADIUM DR STE 1
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:269-375-9450
Practice Address - Fax:269-375-9465
Is Sole Proprietor?:No
Enumeration Date:2008-08-15
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1070433225X00000X
IL056.007559225X00000X
MI5201011268225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist