Individual
CARISSA MONTAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
(616) 840-8000
Mailing address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
(616) 840-8000
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201011009
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5201011009
STATE OF MICHIGAN
MI
Enumeration date
12/08/2020
Last updated
01/21/2026
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