| NPI | 1437506383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT STASZAK Owner 989-860-0846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: MI 5201009073) |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2022-01-12 |