Individual
MRS. KENDELL RAE ALTENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
5900 BYRON CENTER AVE SW, WYOMING, MI 49519-9606
(616) 252-5012
Mailing address
5900 BYRON CENTER AVE SW, WYOMING, MI 49519-9606
(616) 252-5012
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202007419
MI
Other
Enumeration date
03/16/2018
Last updated
03/16/2018
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