Individual
KELLY JO TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
27240 HAGGERTY RD STE E15, FARMINGTON HILLS, MI 48331-5716
(248) 488-0350
(248) 488-0355
Mailing address
27240 HAGGERTY RD STE E15, FARMINGTON HILLS, MI 48331-5716
(248) 488-0350
(248) 488-0355
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001661A
IN
Other
Enumeration date
11/25/2008
Last updated
11/25/2008
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