Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 5202007834 | MI |
NPI | 1003335316 |
---|---|
Provider Name | Mrs. Sharon Marie Mcphail |
First Address | Pinckney, MI 48169-8711 |
Second Address | Pinckney, MI 48169 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2017 |
Last Update Date | 18/09/2017 |