Individual
ELLEN DISLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
27240 HAGGERTY RD # 15, FARMINGTON HILLS, MI 48331-5716
(248) 488-0350
Mailing address
1586 PREIDT CIR, FRANKLIN, IN 46131-7589
(248) 488-0350
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001539A
IN
Other
Enumeration date
03/21/2011
Last updated
03/21/2011
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