Provider Demographics
NPI:1134787104
Name:MCPHAIL, BETH (MSOT, OTRL)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:MCPHAIL
Suffix:
Gender:F
Credentials:MSOT, OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5870 COTTAGE DR
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:MI
Mailing Address - Zip Code:49615-9221
Mailing Address - Country:US
Mailing Address - Phone:989-714-1590
Mailing Address - Fax:
Practice Address - Street 1:4543 S M 88 HWY
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:MI
Practice Address - Zip Code:49615-9109
Practice Address - Country:US
Practice Address - Phone:231-533-8661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-04
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201010553225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist