Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 5201007712 | MI |
NPI | 1275034894 |
---|---|
Provider Name | Trisha Rose Golden |
First Address | Freeland, MI 48623-8755 |
Second Address | Saginaw, MI 48604-2841 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2018 |
Last Update Date | 28/02/2018 |