Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist |
NPI | 1003405044 |
---|---|
Provider Name | Lena Storey |
First Address | Dearborn Heights, MI 48125-1860 |
Second Address | Troy, MI 48084-1774 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2021 |
Last Update Date | 14/01/2021 |