Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 5201009378 | MI |
NPI | 1003277807 |
---|---|
Provider Name | Melanie Muszynski |
First Address | Ovid, MI 48866-9569 |
Second Address | Ovid, MI 48866-9569 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2016 |
Last Update Date | 08/03/2016 |