Provider Demographics
NPI:1972049898
Name:ASEL-TEMPLIN, DENAE (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:DENAE
Middle Name:
Last Name:ASEL-TEMPLIN
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 E MAIN ST UNIT 208
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-6553
Mailing Address - Country:US
Mailing Address - Phone:989-415-9124
Mailing Address - Fax:
Practice Address - Street 1:9 E MAIN ST UNIT 208
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-6553
Practice Address - Country:US
Practice Address - Phone:989-415-9124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201009587225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist