Provider Demographics
NPI:1679084552
Name:ORR, MARY KATHERINE (MS, ATC, LAT)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:KATHERINE
Last Name:ORR
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Gender:
Credentials:MS, ATC, LAT
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:33900 HARPER AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-4258
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6405 TELEGRAPH RD STE F1
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48301-1775
Practice Address - Country:US
Practice Address - Phone:248-633-2980
Practice Address - Fax:248-633-2981
Is Sole Proprietor?:No
Enumeration Date:2017-10-18
Last Update Date:2025-02-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI26010026172255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer