Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist |
NPI | 1003233974 |
---|---|
Provider Name | Maria Giese |
First Address | Lawrence, MI 49064 |
Second Address | Lawrence, MI 49064 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2014 |
Last Update Date | 27/03/2014 |