Individual
MICHELLE TESHOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1000 EDISON AVE NW, GRAND RAPIDS, MI 49504-3918
(630) 303-2846
Mailing address
3510 TRAIL WEST DR NE, GRAND RAPIDS, MI 49525-9426
(630) 303-2846
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056012072
IL
225X00000X
Occupational Therapist
Primary
5201010791
MI
Other
Enumeration date
08/18/2017
Last updated
06/01/2023
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