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Individual

KAVITA SURYAVANSHI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
404 W NEPESSING ST, SUITE B, LAPEER, MI 48446-2150
(810) 245-1900
(810) 245-9080
Mailing address
404 W NEPESSING ST, SUITE B, LAPEER, MI 48446-2150
(810) 245-1900
(810) 245-9080

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201002431
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5201002431
BCBS
Enumeration date
09/04/2008
Last updated
09/04/2008
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