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Individual

MEREDITH NACKLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MOT, OTR/L

Contact information

Practice address
26440 BERG RD, UNIT 1006, SOUTHFIELD, MI 48033-5394
(315) 534-9747
Mailing address
26440 BERG RD, UNIT 1006, SOUTHFIELD, MI 48033-5394
(315) 534-9747

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
5201009134
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5201009134
STATE OF MICHIGAN
MI
Enumeration date
06/05/2015
Last updated
06/05/2015
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