Provider Demographics
NPI:1366589178
Name:REID, CLAUDETTE STORK (OT)
Entity type:Individual
Prefix:MS
First Name:CLAUDETTE
Middle Name:STORK
Last Name:REID
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1524 DOGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-5236
Mailing Address - Country:US
Mailing Address - Phone:269-329-7183
Mailing Address - Fax:269-329-7183
Practice Address - Street 1:1048 PIERPONT DR
Practice Address - Street 2:SUITE 6
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-5976
Practice Address - Country:US
Practice Address - Phone:517-241-0382
Practice Address - Fax:517-241-0375
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201000317225XE1200X, 225X00000X, 225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225XE1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistErgonomics
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Not Answered225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation