Individual
MS. VANESSA ANN OGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1339 BROADWAY ST, NILES, MI 49120-2120
(269) 362-9418
Mailing address
1339 BROADWAY ST, NILES, MI 49120-2120
(269) 362-9418
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32000484A
IN
Other
Enumeration date
09/18/2009
Last updated
09/09/2011
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