Provider Demographics
NPI:1710918685
Name:RAY, DEEPIKA MALIK (MHS OTR)
Entity Type:Individual
Prefix:MS
First Name:DEEPIKA
Middle Name:MALIK
Last Name:RAY
Suffix:
Gender:F
Credentials:MHS OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2092 HENDRIE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-4686
Mailing Address - Country:US
Mailing Address - Phone:248-767-5698
Mailing Address - Fax:
Practice Address - Street 1:2092 HENDRIE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-4686
Practice Address - Country:US
Practice Address - Phone:248-767-5698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201005890225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist