Provider Demographics
NPI:1881108173
Name:JANOWIAK, ASHLEY M (OTR/L)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:JANOWIAK
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 ALGER ST SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49507-3808
Mailing Address - Country:US
Mailing Address - Phone:616-286-8924
Mailing Address - Fax:
Practice Address - Street 1:1095 MEDICAL PARK DR SE # DE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-3685
Practice Address - Country:US
Practice Address - Phone:616-949-7220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-22
Last Update Date:2025-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201011252225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist