Individual
GRETCHEN BLASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22546 CRANBROOK ST, WOODHAVEN, MI 48183-1433
(734) 262-5218
Mailing address
22546 CRANBROOK ST, WOODHAVEN, MI 48183-1433
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 00927
OH
Other
Enumeration date
11/21/2012
Last updated
11/21/2012
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