Provider Demographics
NPI:1801143573
Name:HIRZEL, KRISTINE ANNE (OTR/L)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:ANNE
Last Name:HIRZEL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MICHIGAN AVE W STE 103
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-3632
Mailing Address - Country:US
Mailing Address - Phone:269-441-9300
Mailing Address - Fax:
Practice Address - Street 1:200 MICHIGAN AVE W STE 103
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-3632
Practice Address - Country:US
Practice Address - Phone:269-441-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-13
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201005334225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology