Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 5201008033 | MI |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 5201008033 | MI |
NPI | 1962871400 |
---|---|
Provider Name | Holly Grieves |
First Address | Grand Rapids, MI 49506-4304 |
Second Address | Grand Rapids, MI 49506-4304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2015 |
Last Update Date | 08/02/2017 |