Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 5201001328 | MI |
NPI | 1669965075 |
---|---|
Provider Name | Mrs. Jean Carey Remillet |
First Address | Grosse Pointe, MI 48230-1289 |
Second Address | Detroit, MI 48201-2417 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2018 |
Last Update Date | 11/06/2018 |