Individual
LAURIE ANN MACK-COCKERILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
355 HURONVIEW BLVD, ANN ARBOR, MI 48103-2949
(734) 887-8700
Mailing address
4121 NANCY DR, BRIGHTON, MI 48114-9207
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201001410
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5201001410
MICHIGAN OT LICENSE
MI
Enumeration date
08/01/2018
Last updated
08/01/2018
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