Individual
CARISSA MARIE COUSINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4029 SOUTHWELL DR, PARMA, MI 49269-9419
(734) 772-7443
Mailing address
4029 SOUTHWELL DR, PARMA, MI 49269-9419
(734) 772-7443
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502004314
MI
Other
Enumeration date
08/14/2019
Last updated
08/14/2019
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