Provider Demographics
NPI:1942698923
Name:HUS, ALLEN MICHAEL (OTR/L)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:MICHAEL
Last Name:HUS
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1113 OWANA AVENUE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-3437
Mailing Address - Country:US
Mailing Address - Phone:810-614-1294
Mailing Address - Fax:
Practice Address - Street 1:1113 OWANA AVE
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-3437
Practice Address - Country:US
Practice Address - Phone:810-614-1294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-29
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201008590225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation