Individual
MRS. LAURA DENISE MCDONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
27450 SCHOENHERR RD, 100, WARREN, MI 48088-6683
(586) 582-7825
(586) 582-7826
Mailing address
1309 PLAYER DR, TROY, MI 48085-3372
(248) 879-3706
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201001089
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5171931
—
MI
Enumeration date
05/24/2007
Last updated
07/08/2007
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