KENDRA ETTEMA CTRS MDIV NPI 1639845357

NPI Information

  • NPI: 1639845357
  • Provider Name: KENDRA ETTEMA, CTRS, MDIV
  • Classification: Recreation Therapist - 225800000X
  • Entity Type: Individual
  • Address: 38257 MOUND RD BLDG D
    STERLING HEIGHTS, MI
    ZIP 48310
  • Phone: (586) 722-7524

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NPI Details

Kendra Ettema, CTRS, MDIV is a recreation therapist in Sterling Heights, MI. The provider is a recreation therapist uses recreational activities for intervention in some physical, social or emotional behavior to bring about a desired change in that behavior and promote the growth and development of the patient. Kendra Ettema, CTRS, MDIV NPI is 1639845357. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

38257 MOUND RD BLDG D
STERLING HEIGHTS, MI
ZIP 48310-466
Phone: (586) 722-7524

The enumeration date for this NPI number is 8/22/2021 and was last updated on 8/22/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1225800000XRecreation Therapist59050MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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