Amie Dawn Detharidge OTRL

NPI 1407115215 - Occupational Therapist - 225X00000X

NPI Details
NPI 1407115215
Gender Female
Enumeration Date 05/14/2012
Last Updated 05/14/2012
Entity Type Individual
Active Over 4 years ago
Practice Location
13101 ALLEN RD
SOUTHGATE MI, 48195-2216, US
Phone (734) 785-7700
Fax
Business Location
29506 CLARITA ST
LIVONIA MI, 48152-1944, US
Phone
Fax
Toxanomy
Taxonomy Code 225X00000X
License State Michigan
License Number 5201007935
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According to our database, Mrs. Amie Dawn Detharidge OTRL NPI is 1407115215, taxonomy code is 225X00000X and license number is 5201007935, license state is located at Michigan. Amie Dawn Detharidge OTRL physically located at 13101 Allen Rd, Southgate MI, 48195-2216. NPI Number Amie Dawn Detharidge OTRL has the Individual type.

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1407115215 NPI number is provided on an as is basis without warranty of any kind. 1407115215 is maintained by the National Plan & Provider Enumeration System. The contents of Amie Dawn Detharidge OTRL are for informational purposes only.