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Individual

MISS CARRIE M ENGEMANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
2161 LEONARD ST NW, GRAND RAPIDS, MI 49504-3829
(616) 453-7715
Mailing address
1515 BALL AVE NE, GRAND RAPIDS, MI 49505-5615

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201006660
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5201006660
OCCUPATIONAL THERAPIST
MI
Enumeration date
06/12/2007
Last updated
07/08/2007
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