Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 5201002980 | MI |
N | 225XG0600X | Occupational Therapist - Gerontology | 5201002980 | MI |
N | 225XM0800X | Mental Health | 5201002980 | MI |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 5201002980 | MI |
NPI | 1992016513 |
---|---|
Provider Name | Ms. Karen Marie Maguire |
First Address | Detroit, MI 48226-1400 |
Second Address | Detroit, MI 48226-1400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2010 |
Last Update Date | 29/06/2010 |