Provider Demographics
NPI:1861916728
Name:GYSBERS, ERIN MCLAIN (MOT, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:MCLAIN
Last Name:GYSBERS
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:MISS
Other - First Name:ERIN
Other - Middle Name:LYNN
Other - Last Name:MCLAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOT, OTR/L
Mailing Address - Street 1:121 S GARFIELD AVE STE A
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-2967
Mailing Address - Country:US
Mailing Address - Phone:231-735-1185
Mailing Address - Fax:
Practice Address - Street 1:121 S GARFIELD AVE STE A
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-2967
Practice Address - Country:US
Practice Address - Phone:231-735-1185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201007914225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist