Provider Demographics
NPI:1336434331
Name:OGOY-FERRER, MARY JANE (PT)
Entity Type:Individual
Prefix:
First Name:MARY JANE
Middle Name:
Last Name:OGOY-FERRER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4807 BRUNER DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-2604
Mailing Address - Country:US
Mailing Address - Phone:248-495-0605
Mailing Address - Fax:586-939-4051
Practice Address - Street 1:43191 DALCOMA DR STE 105
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-6308
Practice Address - Country:US
Practice Address - Phone:586-646-2962
Practice Address - Fax:586-480-2842
Is Sole Proprietor?:No
Enumeration Date:2011-06-17
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501007902225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist