Provider Demographics
NPI:1194591958
Name:BRONNER, CLAIRE THERESE (OTR)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:THERESE
Last Name:BRONNER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:THERESE
Other - Last Name:RYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:9368 N LILLEY RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-4610
Mailing Address - Country:US
Mailing Address - Phone:734-462-3240
Mailing Address - Fax:734-462-3831
Practice Address - Street 1:37250 5 MILE RD UNIT D-1
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-1848
Practice Address - Country:US
Practice Address - Phone:734-462-3240
Practice Address - Fax:734-462-3831
Is Sole Proprietor?:No
Enumeration Date:2023-12-01
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201014204225X00000X
TX122986225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand