Provider Demographics
NPI:1427520923
Name:REIMER, CARLY ELIZABETH (OTR/L)
Entity type:Individual
Prefix:MISS
First Name:CARLY
Middle Name:ELIZABETH
Last Name:REIMER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:CARLY
Other - Middle Name:
Other - Last Name:CRIBBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1864 R W BERENDS DR SW APT 8
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49519-4903
Mailing Address - Country:US
Mailing Address - Phone:248-930-6562
Mailing Address - Fax:
Practice Address - Street 1:11007 RADCLIFF DR
Practice Address - Street 2:
Practice Address - City:ALLENDALE
Practice Address - State:MI
Practice Address - Zip Code:49401-9521
Practice Address - Country:US
Practice Address - Phone:616-895-6688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-20
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
MI5201010370225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist