Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | ||
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | MI |
NPI | 1982105946 |
---|---|
Provider Name | Amy Lynne Haroff |
First Address | Kentwood, MI 49548-7620 |
Second Address | Grand Rapids, MI 49503-5247 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2018 |
Last Update Date | 26/02/2018 |