Provider Demographics
NPI:1760209902
Name:POSH, TERESE LOUISE I (OTD)
Entity type:Individual
Prefix:
First Name:TERESE
Middle Name:LOUISE
Last Name:POSH
Suffix:I
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:TESS
Other - Middle Name:LOUISE
Other - Last Name:POSH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTD
Mailing Address - Street 1:9294 WOODRING ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-3758
Mailing Address - Country:US
Mailing Address - Phone:734-649-7215
Mailing Address - Fax:
Practice Address - Street 1:5301 MCAULEY DR
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1051
Practice Address - Country:US
Practice Address - Phone:734-712-3456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201013996225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist