Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 5201003200 | MI |
NPI | 1164721049 |
---|---|
Provider Name | Therese M Williams |
First Address | Clinton Township, MI 48038-1653 |
Second Address | Clarkston, MI 48346-1569 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2011 |
Last Update Date | 18/03/2011 |