Provider Demographics
NPI:1861635179
Name:HUOTARI, TERANEH JEAN (MPT)
Entity Type:Individual
Prefix:MRS
First Name:TERANEH
Middle Name:JEAN
Last Name:HUOTARI
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27427 SCHOENHERR RD STE 200
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-4729
Mailing Address - Country:US
Mailing Address - Phone:586-754-4417
Mailing Address - Fax:586-754-4473
Practice Address - Street 1:27427 SCHOENHERR RD STE 200
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-4729
Practice Address - Country:US
Practice Address - Phone:586-754-4417
Practice Address - Fax:586-754-4473
Is Sole Proprietor?:No
Enumeration Date:2009-04-16
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501010987225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist