Provider Demographics
NPI:1841362373
Name:HASKIN-KARTY, ROXANNE RAE (OT)
Entity type:Individual
Prefix:MRS
First Name:ROXANNE
Middle Name:RAE
Last Name:HASKIN-KARTY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MRS
Other - First Name:ROXANNE
Other - Middle Name:RAE
Other - Last Name:HASKIN-KARTY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OT
Mailing Address - Street 1:10524 EAST GRAND RIVER
Mailing Address - Street 2:SUITE 107 UNIT B
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-9597
Mailing Address - Country:US
Mailing Address - Phone:810-225-7305
Mailing Address - Fax:810-225-7306
Practice Address - Street 1:10524 EAST GRAND RIVER
Practice Address - Street 2:SUITE 107 UNIT B
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-9597
Practice Address - Country:US
Practice Address - Phone:810-225-7305
Practice Address - Fax:810-225-7306
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201002517225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP10090001Medicare ID - Type Unspecified