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Individual

MISS MARYANNE RAKIDZIOSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.O.T

Contact information

Practice address
5201 CONNER ST, DETROIT, MI 48213-3405
(773) 595-6277
Mailing address
1328 CARRIAGE LANE, WINDSOR, ONTARIO N9H1Z-9
(773) 595-6277

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.008476
IL
225X00000X
Occupational Therapist
12818
FL
225X00000X
Occupational Therapist
5201007169
MI
225X00000X
Occupational Therapist
OT9687
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1073795845
IL
Enumeration date
12/03/2007
Last updated
10/24/2024
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