Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 5201007348 | MI |
NPI | 1760140669 |
---|---|
Provider Name | Ms. Doreena Marie Dunning |
First Address | Saint Joseph, MI 49085-1742 |
Second Address | Saint Joseph, MI 49085-9562 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2021 |
Last Update Date | 08/12/2021 |