| Functional Kids | |
|
777 Goguac St W Ste B2 Springfield MI 49015-2097 | |
| (269) 832-8224 | |
| Not Available |
| Full Name | Functional Kids |
|---|---|
| Speciality | Occupational Therapist |
| Location | 777 Goguac St W Ste B2, Springfield, Michigan |
| Authorized Official Name and Position | Maria M Dobbertien (OCCUPATIONAL THERAPIST) |
| Authorized Official Contact | 2698328224 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Functional Kids 777 Goguac St W Ste B2 Springfield MI 49015-2097 Ph: (269) 832-8224 | Functional Kids 777 Goguac St W Ste B2 Springfield MI 49015-2097 Ph: (269) 832-8224 |
| NPI Number | 1578951380 |
|---|---|
| Provider Enumeration Date | 12/31/2014 |
| Last Update Date | 03/08/2024 |
| Certification Date | 03/08/2024 |
| Medicare PECOS PAC ID | 6800116633 |
|---|---|
| Medicare Enrollment ID | O20150519002144 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578951380 | NPI | - | NPPES |
| Provider Name | Maria M Dobbertien |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1093103020 PECOS PAC ID: 0446575989 Enrollment ID: I20150204001946 |
| Provider Name | Jennifer L Roelof |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1053835124 PECOS PAC ID: 6800168691 Enrollment ID: I20170814001451 |
| Provider Name | Gail A Conlan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1083978704 PECOS PAC ID: 8527334366 Enrollment ID: I20171024001140 |
| Provider Name | Ellen R Rosevear |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1649772229 PECOS PAC ID: 8628322658 Enrollment ID: I20181110000363 |
| Provider Name | Lori M Davis |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497993133 PECOS PAC ID: 5890036156 Enrollment ID: I20190415001134 |
| Provider Name | Danielle M Hackert |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1730745753 PECOS PAC ID: 1254664584 Enrollment ID: I20190531000772 |
| Provider Name | Emme Duranczyk |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1053865543 PECOS PAC ID: 5294167763 Enrollment ID: I20191121002000 |
| Provider Name | Alyssa C Rohr |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1386285187 PECOS PAC ID: 7618395229 Enrollment ID: I20200915000229 |
| Provider Name | Kiley S Eversole |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1265960090 PECOS PAC ID: 9436577046 Enrollment ID: I20200915000232 |
| Provider Name | Leah C. Krosschell |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1669047403 PECOS PAC ID: 6406234251 Enrollment ID: I20220607000916 |
| Provider Name | Sheryl Dudley |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1427703990 PECOS PAC ID: 4082096557 Enrollment ID: I20220729002365 |
| Provider Name | Sophie Grelson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1841945300 PECOS PAC ID: 4385026822 Enrollment ID: I20220801001672 |
| Provider Name | Katia Littrell |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1144950577 PECOS PAC ID: 8729460274 Enrollment ID: I20220801002265 |
| Provider Name | Kelly Gottschall |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1003465071 PECOS PAC ID: 3072996446 Enrollment ID: I20220817002431 |
| Provider Name | Anna T Leibovich |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1114302478 PECOS PAC ID: 2163808411 Enrollment ID: I20221010003266 |
| Provider Name | Taylor L Olko |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1013622364 PECOS PAC ID: 1557726429 Enrollment ID: I20230427001879 |
| Provider Name | Amy M Steinman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669093795 PECOS PAC ID: 2961849153 Enrollment ID: I20240323000251 |
| Provider Name | Bailey Towns |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1154177145 PECOS PAC ID: 3375985039 Enrollment ID: I20240525000114 |
| Provider Name | Rene M Cummings |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1831479906 PECOS PAC ID: 3375085020 Enrollment ID: I20240610000695 |