Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist |
NPI | 1003478231 |
---|---|
Provider Name | Mrs. Stephanie Harshman |
First Address | Portage, MI 49002-6817 |
Second Address | Kalamazoo, MI 49001-2860 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2019 |
Last Update Date | 09/07/2019 |