Provider Demographics
NPI:1740777119
Name:SCHIMMEL, BERNICE ELIZABETH (OTRL)
Entity Type:Individual
Prefix:
First Name:BERNICE
Middle Name:ELIZABETH
Last Name:SCHIMMEL
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2214 ILLINOIS AVE
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48506-3726
Mailing Address - Country:US
Mailing Address - Phone:810-965-5524
Mailing Address - Fax:
Practice Address - Street 1:9317 VIENNA RD
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:MI
Practice Address - Zip Code:48457-9729
Practice Address - Country:US
Practice Address - Phone:810-639-6171
Practice Address - Fax:810-639-0052
Is Sole Proprietor?:No
Enumeration Date:2018-04-20
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201007757225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist