Individual
GABRIELLA MARIE AUGUSTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR, C/NDT
Contact information
Practice address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
(616) 840-9763
Mailing address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
(708) 717-9846
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201009494
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1306876438
KINDRED AT HOME
—
Enumeration date
03/08/2018
Last updated
12/14/2021
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