Individual
STACY BOMMELJE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
731 STARKWEATHER DR, LANSING, MI 48917-1128
(517) 323-9133
(517) 323-0092
Mailing address
731 STARKWEATHER DR, LANSING, MI 48917-1128
(517) 323-9133
(517) 323-0092
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202007780
MI
Other
Enumeration date
04/27/2014
Last updated
04/27/2014
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