Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 5201000235 | MI |
NPI | 1992915680 |
---|---|
Provider Name | Mrs. Sandra Kay Fogarty |
First Address | Ann Arbor, MI 48108-9574 |
Second Address | Ann Arbor, MI 48108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 08/07/2007 |