Individual
MICHELLE MARIE LAVIOLETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTAL
Contact information
Practice address
2701 CHESTNUT STATION CT, LOUISVILLE, KY 40299-6395
(800) 335-1060
Mailing address
4127 CUSTER AVE, FLINT, MI 48507-2725
(810) 399-8613
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202008478
MI
Other
Enumeration date
03/19/2019
Last updated
03/19/2019
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