Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 5201010541 | MI |
NPI | 1528628443 |
---|---|
Provider Name | Aaron Swiecicki |
First Address | Bay City, MI 48708-4209 |
Second Address | Bay City, MI 48708-4209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2019 |
Last Update Date | 13/06/2019 |