Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 5201003858 | MI |
NPI | 1003385741 |
---|---|
Provider Name | Deborah Kaye Hagey |
First Address | Saint Joseph, MI 49085-9151 |
Second Address | Saint Joseph, MI 49085-9151 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2018 |
Last Update Date | 23/11/2018 |