Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 5201009135 | MI |
NPI | 1033609664 |
---|---|
Provider Name | Kimberly Anne Rolina |
First Address | Farmington Hills, MI 48331-3286 |
Second Address | Chelsea, MI 48118-1383 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2018 |
Last Update Date | 18/05/2018 |