Provider Demographics
NPI:1295299147
Name:ZIEGLER, DAWN E (COTAL)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:E
Last Name:ZIEGLER
Suffix:
Gender:F
Credentials:COTAL
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:E
Other - Last Name:KELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTAL
Mailing Address - Street 1:7050 FOXRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-3586
Mailing Address - Country:US
Mailing Address - Phone:734-812-2477
Mailing Address - Fax:
Practice Address - Street 1:29667 WENTWORTH ST
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-6231
Practice Address - Country:US
Practice Address - Phone:734-261-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-24
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI52020004224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant