Individual
REBECCA GWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3368 WARRINGHAM AVE, WATERFORD, MI 48329-3054
(248) 760-5645
Mailing address
3368 WARRINGHAM AVE, WATERFORD, MI 48329-3054
(248) 760-5645
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202007674
MI
Other
Enumeration date
06/03/2014
Last updated
06/03/2014
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