Provider Demographics
NPI:1881917243
Name:ACKERSON, ALLISON (OTR/L)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:ACKERSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:TONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:350 BRENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PINCKNEY
Mailing Address - State:MI
Mailing Address - Zip Code:48169-8751
Mailing Address - Country:US
Mailing Address - Phone:517-881-2401
Mailing Address - Fax:810-231-6906
Practice Address - Street 1:350 BRENTWOOD DR
Practice Address - Street 2:
Practice Address - City:PINCKNEY
Practice Address - State:MI
Practice Address - Zip Code:48169-8751
Practice Address - Country:US
Practice Address - Phone:517-881-2401
Practice Address - Fax:810-231-6906
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-12
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201007604225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist