Provider Demographics
NPI:1891840245
Name:BARTELL, MAEGAN CATHERINE (OTR)
Entity Type:Individual
Prefix:
First Name:MAEGAN
Middle Name:CATHERINE
Last Name:BARTELL
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9160 NATHALINE
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48239-1926
Mailing Address - Country:US
Mailing Address - Phone:734-637-7554
Mailing Address - Fax:
Practice Address - Street 1:729 W ANN ARBOR TRL
Practice Address - Street 2:SUITE200
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1631
Practice Address - Country:US
Practice Address - Phone:188-841-4705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201006429225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist