Provider Demographics
NPI:1730819459
Name:TREMP, GABRIELLE ELIZABETH (MSOT, OTRL)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:ELIZABETH
Last Name:TREMP
Suffix:
Gender:F
Credentials:MSOT, OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4920 CRESTONE WAY
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48306-1682
Mailing Address - Country:US
Mailing Address - Phone:248-804-5106
Mailing Address - Fax:
Practice Address - Street 1:11878 HUBBARD ST
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1733
Practice Address - Country:US
Practice Address - Phone:734-953-1745
Practice Address - Fax:734-953-1743
Is Sole Proprietor?:No
Enumeration Date:2022-06-15
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201012850225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist