Provider Demographics
NPI:1730782293
Name:DESAI, RAVINA (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:RAVINA
Middle Name:
Last Name:DESAI
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:RAVINA
Other - Middle Name:
Other - Last Name:NAKUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1800 W US HIGHWAY 223
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-8439
Mailing Address - Country:US
Mailing Address - Phone:517-263-3378
Mailing Address - Fax:
Practice Address - Street 1:375 ADRIATIC PKWY
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75072-1553
Practice Address - Country:US
Practice Address - Phone:214-856-3566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX121622225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist