Individual
KIMBERLY KOSKELA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2295 E VERNOR HWY, DETROIT, MI 48207-3308
(313) 923-5816
Mailing address
25291 WARREN DR, BROWNSTOWN, MI 48134-9196
(313) 420-9190
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202008381
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XYQ910206243
BLUE CROSS BLUE SHEILD
MI
Enumeration date
01/03/2023
Last updated
01/03/2023
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