Provider Demographics
NPI:1811209794
Name:SCHWARTZ, MARY ANN (OTRL)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:ANN
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:ANN
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PSC 9
Mailing Address - Street 2:BOX 10000
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09123-9998
Mailing Address - Country:US
Mailing Address - Phone:011496-565-9560
Mailing Address - Fax:
Practice Address - Street 1:19450 WATERLOO RD
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-9017
Practice Address - Country:US
Practice Address - Phone:734-475-0291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201002405225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist