Individual
MARJORIE JEAN SHOUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1430 MONROE AVE NW, GRAND RAPIDS, MI 49505-4680
(616) 685-8800
Mailing address
8335 COWAN LAKE DR NE, ROCKFORD, MI 49341-9037
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201000305
MI
Other
Enumeration date
10/03/2023
Last updated
10/03/2023
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