Individual
LISA MARIE MANTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
10909 HANNAN RD., ROMULUS, MI 48174
(989) 351-0297
Mailing address
10909 HANNAN RD., ROMULUS, MI 48174
(989) 351-0297
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202006815
MI
Other
Enumeration date
02/21/2021
Last updated
11/03/2023
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