Individual
MS. LAUREL GAUDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1333 WELLS ST, NILES, MI 49120-1543
(269) 240-7780
Mailing address
30 S 4TH ST APT 2, NILES, MI 49120-2743
(269) 240-7780
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
32001655A
IN
224Z00000X
Occupational Therapy Assistant
Primary
5202007304
MI
Other
Enumeration date
05/31/2018
Last updated
05/31/2018
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