Individual
TARA BIVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5659 STADIUM DR, KALAMAZOO, MI 49009-1932
(269) 372-0436
Mailing address
15005 E Q AVE, CLIMAX, MI 49034-9764
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
5201007551
MI
Other
Enumeration date
12/30/2013
Last updated
12/30/2013
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