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1568998003
VICTORIA LYNN FAIRLEY-GREEN
LIVONIA, MI
NPI
1568998003
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: MI 5202007270)
Enumeration Date
2017-05-03
Last Update Date
2017-05-03
Business Address
-- VICTORIA LYNN FAIRLEY-GREEN COTAL
17177 N LAUREL PARK DR STE 417
LIVONIA, MI 48152-3952
Phone number: 734-666-5995
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Mailing Address
-- VICTORIA LYNN FAIRLEY-GREEN COTAL
29221 MARK AVE
MADISON HEIGHTS, MI 48071-4469
Phone number: 248-677-4174
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