Provider Demographics
NPI:1871777250
Name:LOMINAC, ALISHA ANN (OTR)
Entity type:Individual
Prefix:MRS
First Name:ALISHA
Middle Name:ANN
Last Name:LOMINAC
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 GITTINS ST
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48382-3744
Mailing Address - Country:US
Mailing Address - Phone:248-366-4444
Mailing Address - Fax:
Practice Address - Street 1:8900 GITTINS ST
Practice Address - Street 2:
Practice Address - City:COMMERCE TWP
Practice Address - State:MI
Practice Address - Zip Code:48382-3744
Practice Address - Country:US
Practice Address - Phone:248-366-4444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-21
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1023453225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI22Medicaid