IndividualActive
Kelly Blake, OTR
NPI 1396223129 · Occupational Therapist · Waterford, MI
Provider details
- NPI number
- 1396223129
- Entity type
- Individual
- Primary specialty
- Occupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- OTR
- Sex
- Male
- Sole proprietor
- No
- License
- 5201004341 (MI)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Established profile(67/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1901 N Telegraph Rd
Waterford, MI 48328-1878
Phone: (248) 836-1000
Street-level locationGet directions
Mailing address
3257 Whitfield Ct
Waterford, MI 48329-2769
Registry dates
- Enumerated
- 2018-08-02
- Last updated
- 2018-08-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.