Individual
DOREEN MARIE DISANTO I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
1410 E 14 MILE RD, MADISON HEIGHTS, MI 48071-1541
(248) 819-0045
Mailing address
15475 ORCHARD RIDGE DR, CLINTON TOWNSHIP, MI 48038-1692
(248) 765-0305
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201001035
MI
Other
Enumeration date
04/11/2018
Last updated
04/11/2018
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