Provider Demographics
NPI:1699811331
Name:MURPHY, RENEE ELAINE (OT)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:ELAINE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:ELAINE
Other - Last Name:LAUNDROCHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:29256 RYAN RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092-4242
Mailing Address - Country:US
Mailing Address - Phone:586-751-6667
Mailing Address - Fax:586-751-1888
Practice Address - Street 1:29256 RYAN RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-4242
Practice Address - Country:US
Practice Address - Phone:586-751-6667
Practice Address - Fax:586-751-1888
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201001586225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist