Provider Demographics
NPI:1326379900
Name:COHEE, JONATHAN LEE (OT)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:LEE
Last Name:COHEE
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3659 WHISPER CV
Mailing Address - Street 2:
Mailing Address - City:PRUDENVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48651-8451
Mailing Address - Country:US
Mailing Address - Phone:989-366-9353
Mailing Address - Fax:
Practice Address - Street 1:3659 WHISPER CV
Practice Address - Street 2:
Practice Address - City:PRUDENVILLE
Practice Address - State:MI
Practice Address - Zip Code:48651-8451
Practice Address - Country:US
Practice Address - Phone:989-366-9353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201003851174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist