Individual
MIRANDA MACKEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTAL
Contact information
Practice address
43478 MEADOWLARK CIR, CLINTON TWP, MI 48036-3352
(586) 840-6053
Mailing address
43478 MEADOWLARK CIR, CLINTON TWP, MI 48036-3352
(586) 840-6053
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202008434
MI
Other
Enumeration date
02/15/2019
Last updated
02/15/2019
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