| NPI | 1417679960 |
|---|---|
| Former Name | STEPHANIE KATHLEEN GROSS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MI 5201013281) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: VA 0131001844) |
| Enumeration Date | 2022-09-12 |
| Last Update Date | 2023-08-21 |