Individual
TAYLA PALACIOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
202 WARREN ST, CHARLOTTE, MI 48813
(517) 983-8992
Mailing address
202 WARREN ST, CHARLOTTE, MI 48813-1910
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
0131001786
VA
224Z00000X
Occupational Therapy Assistant
Primary
5202008234
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5202008234
MI COTA LC
MI
Enumeration date
02/01/2018
Last updated
06/18/2018
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