Provider Demographics
NPI:1831871797
Name:DEOLIVEIRA, AIMEE M (OT)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:M
Last Name:DEOLIVEIRA
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4295 PHEASANT DR
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48506-1733
Mailing Address - Country:US
Mailing Address - Phone:810-394-3990
Mailing Address - Fax:810-715-9981
Practice Address - Street 1:2222 N LAPEER RD
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-8619
Practice Address - Country:US
Practice Address - Phone:810-358-8151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201011114225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist