Individual
LANEE ARLETT WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
45752 UTICA PARK BLVD, UTICA, MI 48315-5950
(330) 402-7541
Mailing address
45752 UTICA PARK BLVD, UTICA, MI 48315-5950
(330) 402-7541
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201009918
MI
Other
Enumeration date
07/30/2020
Last updated
07/30/2020
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