Individual
MIRANDA OSWALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
225 E CENTER ST UNIT B, ITHACA, MI 48847-1456
(989) 388-3534
Mailing address
225 E CENTER ST UNIT B, ITHACA, MI 48847-1456
(989) 388-3534
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
5201010959
MI
Other
Enumeration date
12/09/2016
Last updated
12/15/2022
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