Individual
LAURIE ANN SQUIRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2394 MIDLAND RD, BAY CITY, MI 48706-9402
(989) 671-3502
(989) 671-3502
Mailing address
1868 S VILLA CT, ESSEXVILLE, MI 48732-1835
(616) 550-9704
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2701129799
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06011946
—
MI
Enumeration date
01/09/2019
Last updated
01/09/2019
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