Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 5201004720 | MI |
NPI | 1003459207 |
---|---|
Provider Name | Pemina Singh |
First Address | Troy, MI 48085-3817 |
Second Address | West Bloomfield, MI 48322-3630 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2019 |
Last Update Date | 21/10/2019 |