Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 5201005253 | MI |
NPI | 1265865000 |
---|---|
Provider Name | Rachelle Connon |
First Address | Marquette, MI 49855 |
Second Address | Marquette, MI 49855 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2013 |
Last Update Date | 15/08/2013 |