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Individual

ARCHANA SHIRISHKAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
26699 W 12 MILE RD, STE 202, SOUTHFIELD, MI 48034-1578
(242) 353-3260
(248) 353-3275
Mailing address
38004 FRINGE DR, STERLING HEIGHTS, MI 48310-3053
(248) 353-3260
(248) 353-3275

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201001865
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5201001865
OCCUPATIONAL THERAPY LICE
MI
01
670F302750
BCBSM
MI
Enumeration date
12/22/2006
Last updated
12/21/2010
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