Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 5201008187 | MI |
NPI | 1174953848 |
---|---|
Provider Name | Lauren Oak |
First Address | Kalamazoo, MI 49009-3306 |
Second Address | Kalamazoo, MI 49009-3306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2013 |
Last Update Date | 17/11/2013 |