Individual
MRS. MARILYN LOUISE LEIBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
530 BEECH ST, CHARLOTTE, MI 48813-1016
(517) 543-2940
Mailing address
1264 S ROYSTON RD, EATON RAPIDS, MI 48827-9091
(517) 256-1950
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201000951
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437171485
—
MI
Enumeration date
02/27/2018
Last updated
02/27/2018
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