Organization
MINI MITTEN PEDIATRIC THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASEY BROSS OTD, OTRL, CLT, CLC (OWNER)
(734) 888-6464
Entity
Organization
Contact information
Practice address
7447 N TELEGRAPH RD, MONROE, MI 48162-9328
(734) 888-6464
(734) 275-0985
Mailing address
7447 N TELEGRAPH RD, MONROE, MI 48162-9328
(734) 888-6464
(734) 275-0985
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
Other
Enumeration date
12/21/2020
Last updated
06/05/2025
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