| Doctor Name: | URSULA KOTZABASSI |
| NPI Number: | 1114330263 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | OTRL |
| License Number: | 5201007237 |
| Business Practice Address: | 10909 Hannan Rd Romulus, MI - 481741383 |
| Business Phone Number: | 7348931031 |
| Business Fax Number: | |
| Mailing Address: | 10909 Hannan Rd, ROMULUS |
| State: | MI |
| Postal Code: | 481741383 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 06/06/2014 |
| NPI Last Update Date: | 06/06/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225XN1300X |
| License Number: | 5201007237 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Occupational Therapist |
| Taxonomy Specialization: | Neurorehabilitation |
| Taxonomy Definition: | |