Individual
SHARICE BAUSLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
111 FORD ST, HIGHLAND PARK, MI 48203-3622
(313) 883-3585
Mailing address
10944 WORDEN ST, DETROIT, MI 48224-1166
(313) 469-4555
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5201007382
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5201007382
—
MI
Enumeration date
02/05/2018
Last updated
02/05/2018
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