Individual
GAYATHRI ETHIRAJ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15311 SCHAEFER HWY, DETROIT, MI 48227-3337
(313) 879-4775
Mailing address
452 PRINCETON DR, CANTON, MI 48188-1028
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201007043
MI
Other
Enumeration date
03/30/2019
Last updated
03/30/2019
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