Individual
GRETCHEN GAYLORD FRASER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR, CLT-LANA
Contact information
Practice address
2970 KEEWAYDIN TRL, TRAVERSE CITY, MI 49686-8564
(231) 392-1756
Mailing address
2970 KEEWAYDIN TRL, TRAVERSE CITY, MI 49686-8564
(231) 392-1756
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201003389
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326124322
—
MI
Enumeration date
03/22/2018
Last updated
03/22/2018
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