Individual
SHELLY GERMAINE TEESDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOTR/L
Contact information
Practice address
4450 CASCADE RD SE, GRAND RAPIDS, MI 49546-3633
(616) 949-5140
Mailing address
2063 WINSTON VIEW DR NE, CEDAR SPRINGS, MI 49319-7947
(616) 862-8900
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201007005
MI
Other
Enumeration date
07/24/2018
Last updated
07/24/2018
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