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Individual

MRS. SHERRY PHONE TIP O'BANION

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
320 CHURCH ST., MT CLEMENS, MI 48043
(248) 689-0468
(248) 689-1068
Mailing address
11031 E 12 MILE RD, WARREN, MI 48093-2634
(586) 707-1183

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
213305
TX
224Z00000X
Occupational Therapy Assistant
Primary
5202007792
MI

Other

Enumeration date
02/01/2016
Last updated
09/01/2022
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