Individual
LOUISE FRAGNOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
26001 JEFFERSON AVE, SAINT CLAIR SHORES, MI 48081-2309
(586) 779-7000
Mailing address
47905 FREEDOM VALLEY DR, MACOMB, MI 48044-2597
(586) 779-7000
Taxonomy
Speciality
Code
Description
License number
State
224ZF0002X
Feeding, Eating & Swallowing Occupational Therapy Assistant
Primary
5201005385
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5201005385
—
MI
Enumeration date
05/15/2018
Last updated
06/16/2018
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