Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 5201003961 | MI |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 5201003961 | MI |
N | 225XP0200X | Occupational Therapist - Pediatrics | 5201003961 | MI |
NPI | 1093964652 |
---|---|
Provider Name | Ms. Rosemarie Gene Ells |
First Address | Big Rapids, MI 49307 |
Second Address | Big Rapids, MI 49307-2135 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2008 |
Last Update Date | 18/09/2008 |