Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 5201000435 | MI |
NPI | 1851881098 |
---|---|
Provider Name | Mrs. Deborah Disanto Porter |
First Address | Clinton Township, MI 48038-1104 |
Second Address | Clinton Township, MI 48038-1104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2018 |
Last Update Date | 20/04/2021 |