Provider Demographics
NPI:1780640847
Name:DUMOULIN, DENISE ANN (PT)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:ANN
Last Name:DUMOULIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:DENISE
Other - Middle Name:ANN
Other - Last Name:TOKIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1311 MAMARONECK AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-5224
Mailing Address - Country:US
Mailing Address - Phone:914-294-4050
Mailing Address - Fax:
Practice Address - Street 1:400 ROUNDS DR
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-1724
Practice Address - Country:US
Practice Address - Phone:810-750-1996
Practice Address - Fax:810-750-6361
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501005384225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist