Individual
MANDIE GINELLE OUELLETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
11930 WHITMORE LAKE RD, WHITMORE LAKE, MI 48189-9153
(734) 449-4649
Mailing address
9724 TIOGA TRL, PINCKNEY, MI 48169-8157
(734) 717-7564
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1117065
MI
Other
Enumeration date
12/29/2008
Last updated
12/29/2008
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