Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 5201003946 | MI |
NPI | 1003000605 |
---|---|
Provider Name | Mrs. Diane Elizabeth Freeman |
First Address | Davison, MI 48423-8517 |
Second Address | Davison, MI 48423-8517 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2007 |
Last Update Date | 20/03/2020 |