Provider Demographics
NPI:1245883586
Name:VERTIN, MICHAELA SUSAN (OTR)
Entity type:Individual
Prefix:
First Name:MICHAELA
Middle Name:SUSAN
Last Name:VERTIN
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 1:41449 MISSION LN
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-5247
Mailing Address - Country:US
Mailing Address - Phone:248-880-7779
Mailing Address - Fax:
Practice Address - Street 1:801 CRAWFORD ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23704-3822
Practice Address - Country:US
Practice Address - Phone:757-393-8269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics