Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 5201002048 | MI |
N | 2251E1200X | Ergonomics | 5201002048 | MI |
N | 225XE1200X | Ergonomics | 5201002048 | MI |
N | 225XF0002X | Feeding, Eating & Swallowing | 5201002048 | MI |
N | 225XG0600X | Occupational Therapist - Gerontology | 5201002048 | MI |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 5201002048 | MI |
N | 225XP0200X | Occupational Therapist - Pediatrics | 5201002048 | MI |
NPI | 1497024657 |
---|---|
Provider Name | Karen Pierce Tibbs |
First Address | Southfield, MI 48076-5379 |
Second Address | Southfield, MI 48076-5379 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2011 |
Last Update Date | 17/12/2011 |