Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 5201003538 | MI |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 5201003538 | MI |
NPI | 1407328818 |
---|---|
Provider Name | Ms. Tara Taulbee |
First Address | West Bloomfield, MI 48322-3220 |
Second Address | West Bloomfield, MI 48322-3220 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2018 |
Last Update Date | 23/12/2018 |