Individual
DIANE KAY ELIZONDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
806 WILLIAMS ST, FENTON, MI 48430-2926
(810) 625-6677
Mailing address
806 WILLIAMS ST, FENTON, MI 48430-2926
(810) 625-6677
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202007494
MI
Other
Enumeration date
07/17/2025
Last updated
07/17/2025
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