Provider Demographics
NPI:1528264736
Name:ELANDT, KAREN JEFFERSON (OTR)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:JEFFERSON
Last Name:ELANDT
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6420 CORNERSTONE LN
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48306-4577
Mailing Address - Country:US
Mailing Address - Phone:248-652-0832
Mailing Address - Fax:
Practice Address - Street 1:31201 DORCHESTER AVE
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-1075
Practice Address - Country:US
Practice Address - Phone:248-589-1990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201002512225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist