Individual
KATHLEEN GRASSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
28000 WOODWARD AVE, ROYAL OAK, MI 48067-0960
(483) 953-7772
Mailing address
28000 WOODWARD AVE STE 100, ROYAL OAK, MI 48067-0961
(248) 440-1496
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201011082
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144359764
—
MI
Enumeration date
04/22/2021
Last updated
08/04/2021
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