Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 5201008432 | MI |
N | 225XG0600X | Occupational Therapist - Gerontology | 5201008432 | MI |
NPI | 1679904213 |
---|---|
Provider Name | Nicole Farrand |
First Address | Hale, MI 48739 |
Second Address | Tawas City, MI 48763-9161 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2013 |
Last Update Date | 09/12/2013 |