Individual
TRACIE RENEE THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
12191 JENNINGS RD, LINDEN, MI 48451-9476
(810) 397-3411
Mailing address
111 TREALOUT DR, FENTON, MI 48430-1481
(810) 593-3119
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
09/16/2019
Last updated
09/16/2019
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