Individual
LISA LOGOMARSINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13101 ALLEN RD, SOUTHGATE, MI 48195-2216
(734) 785-7700
Mailing address
910 FERNWOOD RD, ROYAL OAK, MI 48067-1641
(586) 634-7058
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
5201008253
MI
Other
Enumeration date
05/04/2012
Last updated
05/04/2012
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