Individual
SUSANNAH DECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
46130 WEST PARK DR, NOVI, MI 48377
(248) 669-1695
Mailing address
46130 WEST PARK DR, NOVI, MI 48377
(248) 669-1695
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202006109
MI
Other
Enumeration date
10/06/2011
Last updated
10/06/2011
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