Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 5202008534 | MI |
NPI | 1003462995 |
---|---|
Provider Name | Ashleigh Nicole Miling |
First Address | Grand Rapids, MI 49505-3313 |
Second Address | Grand Rapids, MI 49505-3313 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2019 |
Last Update Date | 15/08/2019 |