Provider Demographics
NPI:1386120749
Name:DIMAGUILA, ARLENE DECHAVEZ (OTR/L)
Entity type:Individual
Prefix:
First Name:ARLENE
Middle Name:DECHAVEZ
Last Name:DIMAGUILA
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 1:29823 HIGHMEADOW RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3009
Mailing Address - Country:US
Mailing Address - Phone:248-514-8114
Mailing Address - Fax:
Practice Address - Street 1:15475 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-3805
Practice Address - Country:US
Practice Address - Phone:734-743-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-18
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5021004207225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist