Individual
JODY X YOUNGLOVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.O.T.A.
Contact information
Practice address
610 W ELM AVE, MONROE, MI 48162-7909
(734) 240-9670
Mailing address
610 W ELM AVE, MONROE, MI 48162-7909
(734) 240-9670
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202007063
MI
Other
Enumeration date
09/26/2009
Last updated
09/26/2009
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