Individual
JULIA KATHERINE PENNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
158 HERON DR NW, GRAND RAPIDS, MI 49534-1597
(630) 339-6221
Mailing address
158 HERON DR NW, GRAND RAPIDS, MI 49534-1597
(630) 339-6221
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201011365
MI
Other
Enumeration date
08/03/2021
Last updated
09/18/2023
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