Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 5201009363 | MI |
NPI | 1003387366 |
---|---|
Provider Name | Mr. Daniel Joseph Parsell |
First Address | South Lyon, MI 48178-1085 |
Second Address | Farmington Hills, MI 48331-3287 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2018 |
Last Update Date | 16/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5201009363 | (05) | MI |