Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 5201000317 | MI |
N | 2251E1200X | Ergonomics | 5201000317 | MI |
N | 225XE1200X | Ergonomics | 5201000317 | MI |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 5201000317 | MI |
NPI | 1366589178 |
---|---|
Provider Name | Ms. Claudette Stork Reid |
First Address | Portage, MI 49024-5236 |
Second Address | Lansing, MI 48911-5976 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2007 |
Last Update Date | 08/07/2007 |