Individual
MS. TERESA ANN FAIRGOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
19100 W 7 MILE RD, DETROIT, MI 48219-2758
(313) 532-3723
Mailing address
17354 SPRENGER AVE, EASTPOINTE, MI 48021-3110
(313) 408-9754
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202006745
MI
Other
Enumeration date
02/04/2018
Last updated
02/04/2018
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