Provider Demographics
NPI:1841729704
Name:MCGINNIS, ERYN (OTRL)
Entity type:Individual
Prefix:
First Name:ERYN
Middle Name:
Last Name:MCGINNIS
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:ERYN
Other - Middle Name:
Other - Last Name:DONNELLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTRL
Mailing Address - Street 1:11878 HUBBARD ST STE 100
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-1733
Mailing Address - Country:US
Mailing Address - Phone:734-743-2909
Mailing Address - Fax:
Practice Address - Street 1:11878 HUBBARD ST STE 100
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1733
Practice Address - Country:US
Practice Address - Phone:734-743-2909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201010945225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist