Provider Demographics
NPI:1881282911
Name:DENSLOW, ANNA REED (OTR/L)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:REED
Last Name:DENSLOW
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 1:235 WEALTHY ST SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-5247
Mailing Address - Country:US
Mailing Address - Phone:616-840-7135
Mailing Address - Fax:616-840-9690
Practice Address - Street 1:3290 N WELLNESS DR STE 150
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-8047
Practice Address - Country:US
Practice Address - Phone:616-294-4066
Practice Address - Fax:616-994-6062
Is Sole Proprietor?:No
Enumeration Date:2021-01-05
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
MI5201013787225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician