Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation |
NPI | 1710453592 |
---|---|
Provider Name | Melanie Plank |
First Address | Wixom, MI 48393-1575 |
Second Address | Novi, MI 48377-4515 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2018 |
Last Update Date | 18/10/2018 |