Provider Demographics
NPI:1427872431
Name:L'ESPERANCE, MARTHA JANE (COTA/L)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:JANE
Last Name:L'ESPERANCE
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11110 OAKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BYRON
Mailing Address - State:MI
Mailing Address - Zip Code:48418-9013
Mailing Address - Country:US
Mailing Address - Phone:810-588-3157
Mailing Address - Fax:
Practice Address - Street 1:3003 W GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-8539
Practice Address - Country:US
Practice Address - Phone:517-546-4210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5202010155224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant