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Individual

MRS. GAYLE A MUNRO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
5447 WOODWARD AVE, DETROIT, MI 48202-4009
(313) 832-1100
Mailing address
5447 WOODWARD AVE, DETROIT, MI 48202-4009
(313) 832-1100

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
5202002333
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5202002333
STATE OF MICHIGAN OCCUPATIONAL THERAPY ASSISTANT LICENSE
MI
Enumeration date
07/15/2009
Last updated
07/15/2009
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