Individual
LISA BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
38777 6 MILE RD STE 209, LIVONIA, MI 48152-2660
(248) 762-6501
Mailing address
22947 TUCK RD, FARMINGTON HILLS, MI 48336-3458
(248) 762-6501
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202004300
MI
Other
Enumeration date
03/17/2016
Last updated
03/17/2016
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