| NPI | 1962058545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIENNE RUTHERFORD Administrator 313-854-1180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist Pediatrics |
| Additional Taxonomies | 225XN1300X Occupational Therapist Neurorehabilitation |
| 225XG0600X Occupational Therapist Gerontology | |
| 225XM0800X Occupational Therapist Mental Health | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2019-08-10 |
| Last Update Date | 2021-12-13 |