Provider Demographics
NPI:1962162446
Name:FERENCZY, DEVIN CHRISTINE (PTA)
Entity type:Individual
Prefix:MISS
First Name:DEVIN
Middle Name:CHRISTINE
Last Name:FERENCZY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1947 WHITTAKER RD
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-9432
Mailing Address - Country:US
Mailing Address - Phone:734-879-1138
Mailing Address - Fax:734-879-1156
Practice Address - Street 1:1947 WHITTAKER RD
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-9432
Practice Address - Country:US
Practice Address - Phone:734-879-1138
Practice Address - Fax:734-879-1156
Is Sole Proprietor?:No
Enumeration Date:2021-12-23
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5502006418225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant