Individual
CLARE E CERESNIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
261 MACK AVE, DETROIT, MI 48201
(313) 745-9793
Mailing address
18161 LATHERS ST, LIVONIA, MI 48152-3784
(248) 259-2156
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201008535
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5201008535
OCCUPATIONAL THERAPY LICENSE
MI
Enumeration date
09/23/2010
Last updated
06/12/2018
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