Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 5201000375 | MI |
NPI | 1003317918 |
---|---|
Provider Name | Maureen Ann Kuznicki |
First Address | Farmington Hills, MI 48336-5919 |
Second Address | Farmington Hills, MI 48336-5919 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2018 |
Last Update Date | 26/02/2018 |