Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 5201005865 | MI |
NPI | 1003316670 |
---|---|
Provider Name | Kirstin Delfin |
First Address | Canton, MI 48188-3272 |
Second Address | Wayne, MI 48184-2920 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2018 |
Last Update Date | 20/02/2018 |