Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 5201006291 | MI |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 5201006291 | MI |
NPI | 1023204070 |
---|---|
Provider Name | Mrs. Michelle Ann Holtz |
First Address | Flat Rock, MI 48134-1240 |
Second Address | Flat Rock, MI 48134-1240 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2007 |
Last Update Date | 06/11/2014 |