Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 5201004193 | MI |
NPI | 1366945552 |
---|---|
Provider Name | Ms. Marianne Hassen |
First Address | Toledo, OH 43617-3113 |
Second Address | Monroe, MI 48162-7909 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2018 |
Last Update Date | 14/03/2018 |