Individual
CASSIDY PAULINE BURKHOLDER
Active
Individual
CASSIDY PAULINE BURKHOLDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
52010099009
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497235303
—
MI
Enumeration date
08/20/2018
Last updated
01/28/2020
Update your record
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