Provider Demographics
NPI:1912044660
Name:CRONIN, JANET M (OT)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:M
Last Name:CRONIN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4128 E GRAND RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-6538
Mailing Address - Country:US
Mailing Address - Phone:517-540-1060
Mailing Address - Fax:517-540-1063
Practice Address - Street 1:4128 E GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-6538
Practice Address - Country:US
Practice Address - Phone:517-540-1060
Practice Address - Fax:517-540-1063
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201007071225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI16869OtherM-CARE
MI500573OtherCARE CHOICES
MI7543420OtherAETNA
MIP00100555OtherMEDICARE RAILROAD
MI0H20094OtherBCBS
MI0N58620OtherHAP
MI16869OtherM-CARE